Continuous Wave Transscleral Cyclophotocoagulation and Endoscopic Cyclophotocoagulation in Childhood Glaucoma: A Meta-analysis

Abdelrahman M Elhusseiny; Amr K Hassan; Ahmed S Elsaman; Jamal O Azhari; Deborah K VanderVeen; Salah Abdelnaem; Mohammad Pakravan; Ta C Chang; Mohamed M Khodeiry; Albert S Khouri; Mohamed S Sayed; Richard K Lee; Ahmed B Sallam

doi:10.1097/IJG.0000000000002365

Continuous Wave Transscleral Cyclophotocoagulation and Endoscopic Cyclophotocoagulation in Childhood Glaucoma: A Meta-analysis

J Glaucoma. 2024 Jan 26. doi: 10.1097/IJG.0000000000002365. Online ahead of print.

Authors

Affiliations

¹ Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
² Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
³ Department of Ophthalmology, Faculty of Medicine, South Valley University, Qena, Egypt.
⁴ Department of Immunology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
⁵ Department of Ophthalmology, University of Texas Medical Branch, Galveston, Texas, USA.
⁶ Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL, USA.
⁷ Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ.
⁸ Moorfields Eye Hospital Dubai, Dubai Healthcare City, Dubai, UAE.

PMID: 38506746
DOI: 10.1097/IJG.0000000000002365

Abstract

Purpose: To report the outcomes of continuous wave-transscleral cyclophotocoagulation (TS-CPC) and endoscopic cyclophotocoagulation (ECP) in childhood glaucoma.

Methods: We performed a systematic search of relevant databases. We collected data on age, follow-up duration, type of glaucoma, previous surgical interventions, preoperative and postoperative intraocular pressure (IOP), preoperative and postoperative number of glaucoma medications, adverse events, number of sessions, and success rates at different time points. The main outcome measures are the amount of IOP and glaucoma medication reduction.

Results: We included 17 studies studying 526 patients (658 eyes); 11 evaluated the effectiveness of TS-CPC (268 patients, 337 eyes), 5 evaluated ECP (159 patients, 197 eyes), and one study compared both techniques (56 patients, 72 eyes for TS-CPC vs. 43 patients, 52 eyes for ECP). The median duration of follow-up was 28 months in the TS-CPC group and 34.4 months in the ECP group. The mean number of treatment sessions was 1.7 in the TS-CPC and 1.3 in the ECP. In the TS-CPC group, the mean IOP was significantly reduced from 31.2±8 to 20.8±8 mmHg at the last follow-up (P<0.001). The mean number of glaucoma medications was reduced from 2.3±1.3 to 2.2±1.3 (P=0.37). In the ECP group, there was also a significant reduction in the mean IOP from 32.9±8 mmHg with a mean of 1.7±0.7 glaucoma medications to 22.6±9.8 mmHg (P<0.0001) on 1.2±1.1 medications (P=0.009) at the last follow-up.

Conclusion: Both TS-CPC and ECP were effective in reducing the IOP and glaucoma medications in childhood glaucoma. Multiple treatment sessions were required.