Outcomes of micropulse cyclophotocoagulation for refractory glaucoma in children

PURPOSE: To evaluate the outcomes of micropulse transscleral cyclophotocoagulation (MP-CPC) for refractory glaucoma in children. STUDY DESIGN: Retrospective study. METHODS: We evaluated the data from children with refractory glaucoma who underwent MP-CPC from July 2022 to December 2024 at the National Center for Child Health and Development and who were followed up for at least 3 months. The retrospective analysis included age; glaucoma type; history of glaucoma surgery; intraocular pressure (IOP) at baseline and at 1, 3, and 6 months postoperatively; medication score administered before and after surgery; visual acuity; and complications. RESULTS: Twenty-nine eyes of 24 patients (average age, 101.3 ± 68.1 months) were included in this study. The most common types of glaucoma were glaucoma associated with nonacquired ocular anomalies and glaucoma after cataract surgery, accounting for 11 eyes (37.9%). The average number of glaucoma surgeries performed before treatment was 1.9 ± 1.6. The average follow-up period was 16.1 ± 7.9 months. Using a mixed-effects model, the mean IOP decreased by -9.8 mm Hg at 1 month (P <.01), -7.5 mm Hg at 3 months (P <.01), and -7.4 mm Hg at 6 months (P <.01). The median medication score (interquartile range) decreased from 5 (4-6) preoperatively to 4 (3-5) at 1, 3, and 6 months postoperatively. After undergoing the first MP-CPC, 19 eyes (65.5%) required reoperation for glaucoma. Eleven eyes (37.9%) required reoperation within 6 months postoperatively, and 17 eyes (58.6%) required reoperation within 1 year. CONCLUSION: MP-CPC effectively reduces IOP in children with refractory glaucoma without causing visual impairment or serious complications.