Purpose: To evaluate the usefulness of krypton laser for transscleral contact cyclophotocoagulation (CPC) in the treatment of therapy resistant glaucoma in young patients.
Methods: Transscleral contact krypton laser cyclophotocoagulation was performed in 33 eyes of 27 young patients (11.5 +/- 5.6 years, range 11 months to 19.4 years) with therapy resistant glaucoma. The krypton laser was delivered via a fiberoptic probe with compression of the sclera by the probe. The energy used was 3 to 5 J per application at the tip of the probe, with an exposure time of 10 seconds. Of bilaterally treated patients, one eye was randomly chosen for statistical analysis.
Results: The intraocular pressure (IOP) decreased from the preoperative mean of 35.3 +/- 7.4 mmHg to 21.8 +/- 9.3 mmHg (n=27) at 1 month (P<0.0001), to 24.1 +/- 8.5 mmHg (n=23) at 3 months (P<0.001), to 22.7 +/- 12.1 mmHg (n=24) at 6 months (P<0.001), to 21.9 +/- 8.9 mmHg (n=20) at 1 year (P<0.001), and to 26.0 +/- 10.5 mmHg (n=27, P< 0.001) at the last control visit (mean 28.2 months) after one or more CPC:s. An IOP of 8 to 21 mmHg or a decrease in IOP of more than 30% was obtained in 52% of the eyes. No permanent hypotonia, phtisis bulbi or CPC-related devastating complications were noted.
Conclusion: Krypton laser CPC is a well tolerated means of lowering IOP in young patients, but due to the refractory nature of the disease, repeated treatments may be needed.