Contact transscleral Nd:YAG laser cyclophotocoagulation for the treatment of refractory pediatric glaucoma

BACKGROUND AND OBJECTIVE: Nd:YAG contact transscleral laser cyclophotocoagulation (CTLC) has been used in the treatment of adult glaucoma patients. However, little information is available regarding the use of this modality in pediatric glaucoma. PATIENTS AND METHODS: We retrospectively studied 10 pediatric patients (ages 8 months to 13 years) treated with Nd:YAG CTLC for refractory glaucoma. All patients were treated using our standard technique in an outpatient setting. Average treatment energy was 190.5 +/- 35.0 J. RESULTS: The overall result was an average intraocular pressure (IOP) reduction of 48% +/- 6%. An IOP of less than 21 mm Hg was achieved in five patients (50%), and the average follow up was 15.5 +/- 5 months. Retreatment was required in 7 of 10 eyes. Loss of vision was seen in four patients, and one case of phthisis bulbi was noted. CONCLUSION: Nd:YAG CTLC effectively lowers IOP in refractory pediatric glaucoma.