Micropulse transscleral diode laser for pediatric glaucoma in Sturge-Weber syndrome: A bridge therapy to other treatments.
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BACKGROUND AND OBJECTIVE: To evaluate the efficacy of micropulse transscleral diode laser cyclophotocoagulation as a bridge therapy prior to angle surgery in pediatric glaucoma caused by angle dysgenesis in the context of Sturge-Weber Syndrome. The objective was to temporarily control intraocular pressure, thereby achieving the corneal transparency required for subsequent angle surgery. MATERIALS AND METHODS: Three Sturge-Weber syndrome patients under one year old, with glaucoma caused by angle dysgenesis and corneal opacity, were treated with micropulse transscleral diode laser cyclophotocoagulation to improve corneal transparency before surgery. Two patients subsequently underwent trabeculotomy, while the third patient, who had a previous trabeculotomy, underwent a MIGS OMNI procedure. RESULTS: Micropulse transscleral diode laser cyclophotocoagulation temporarily lowered IOP values, improving corneal transparency and allowing the performance of subsequent surgical interventions. CONCLUSION: The combination of micropulse transscleral diode laser cyclophotocoagulation as a bridge therapy followed by angle surgery, for example trabeculotomy or MIGS OMNI, represents a promising strategy for managing congenital glaucoma in pediatric patients with angle dysgenesis, particularly in the context of phakomatoses like Sturge-Weber Syndrome.