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

Precis: Transscleral cyclophotocoagulation (TS-CPC) and endoscopic cyclophotocoagulation (ECP) were effective in reducing intraocular pressure (IOP) and glaucoma medications in childhood glaucoma. Objective: To report the outcomes of continuous wave TS-CPC and ECP in childhood glaucoma. Materials and 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 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 mm Hg 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 mm Hg with a mean of 1.7 +/- 0.7 glaucoma medications to 22.6 +/- 9.8 mm Hg (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.