Antony Clark, Kamiar Mireskandari, Nasrin Tehrani, Asim Ali
Purpose: To describe the effectiveness of SLT for the treatment of paediatric glaucoma
Methods: Retrospective case series of SLT offered to children (<18 years old) attending clinic with open- angle glaucoma where intraocular pressure (IOP) was not controlled (>21mmHg) on maximal toler- ated medical therapy. SLT was delivered to 180 degrees of the trabecular meshwork. IOP was recorded at 1hr, 1 day, 1 week, 2 weeks, 1 month, 2 months and 3 months post treatment.
Results: Six children (8 eyes) had one treatment of SLT to 180 degrees of trabecular meshwork. Four children (5 eyes) had uveitic glaucoma, one child (2 eyes) had juvenile open angle glaucoma, and one child (1 eye) had glaucoma following cataract sur- gery. The median age was 13.5 years (range 6 –
16 years). All four children (5 eyes) with uveitic glaucoma did not have a signiftcant reduction in IOP. The child with JOAG had a 16% and 11.4% reduction in IOP at 1 month having also stopped Diamox. The child with glaucoma following cataract surgery had a 13.3% reduction in IOP at 1 month. No child experienced an IOP spike. No child devel- oped signiftcant anterior segment in?ammation or peripheral anterior synechiae.
Conclusions: SLT has limited beneftt in children with uveitic glaucoma who are already on maximal medical therapy. SLT provided a useful reduction in IOP juvenile open angle glaucoma and glaucoma following cataract surgery. Further study is needed to explore the effectiveness of SLT and its role in management of paediatric glaucoma.