Transscleral diode laser cyclophotocoagulation for refractory glaucoma secondary to juvenile idiopathic arthritis: a short term follow-up

Abstract

To evaluate the success rates of transscleral diode cyclophotocoagulation (TD-CPC) for refractory secondary glaucoma in a paediatric patient with juvenile idiopathic arthritis. Report of a case of a 6-year-old boy suffering from severe uveitis, and secondary open angle glaucoma. The patient had undergone bilateral cataract surgery, two prior trabeculectomies in the left and one in the right eye. He was under systemic immunomodulation with methotrexate and cyclosporine. He presented with medically uncontrolled glaucoma, with an intraocular pressure (IOP) of 36 and 34mmHg in the right and left eye, respectively, under maximal medical antiglaucoma therapy. TD-CPC was performed under general anesthesia, including a total of 20 spots in the right and 34 in the left eye (2,000mW, 2s/spot) applied in one session. Visual acuity remained stable in the right eye and deteriorated in the left eye from 0.1 to no light perception. Postoperative hypotony was present 1month post op and IOP was 14mmHg in the left and 17mmHg in the right eye, respectively, in the 6-month follow-up with a topical beta-blocker. The anterior chamber was quiet in both eyes. TD-CPC was effective in the short term as IOP lowering therapy in a pediatric patient with refractory uveitic glaucoma.