Cyclodiode Laser as the First Surgical Approach in Childhood Glaucoma Under the Age of 8 Years.

PRCIS: Cyclodiode as a primary treatment for childhood glaucoma patients younger than 8 years has a 12-month success rate of 55.24%. It can delay the need for penetrating glaucoma surgery. PURPOSE: The purpose of this study was to evaluate the treatment outcome of cyclodiode laser in childhood glaucoma for patients under the age of 8 years. DESIGN: This was a retrospective, consecutive, noncomparative case series. PARTICIPANTS: All childhood glaucoma patients who underwent cyclodiode from March 2005 to January 2017 as a primary surgical treatment under the age of 8 years. METHODS: A retrospective review of the medical records of consecutive patients who underwent cyclodiode by a single surgeon. MAIN OUTCOME MEASURES: Success for single-diode intervention was defined as intraocular pressure (IOP) (>6 wk postoperative) ≤21 mm Hg with antiglaucoma medications and ≥20% IOP reduction, no further glaucoma surgery including cyclodiode, no loss of perception of light, and no major complications. Success for multiple-diode interventions was defined similar to the single diode, except that repeated cyclodiode is not considered a failure. RESULTS: In all, 59 eyes of 43 patients were studied. The most common diagnosis was aphakic glaucoma. The mean age at cyclodiode treatment was 2.7 years (SD=2.2). Fifty-six percent of the patients were under 3 years. Success rates at 12 months after the procedure were 46.67% and 55.24% for single-diode and multiple-diode interventions, respectively. An IOP of >20 mm Hg 6 weeks after a cyclodiode session is a significant risk factor for failure with an hazard ratio of 2.41 (95% confidence interval: 1.00-5.81; P=0.05). Among the operated eyes, the surgeon could avoid further glaucoma surgery in 67.8% of the eyes during the first year after single or multiple cyclodiode sessions. None of the eyes experienced phthisis bulbi, hypotony, and severe uveitis. CONCLUSIONS: Cyclodiode laser in childhood glaucoma patients under the age of 8 years can be considered a safe alternative for glaucoma patients who can have a high risk of surgical complications. Performing cyclodiode laser can delay the need for penetrating glaucoma surgery. The IOP at 6 weeks may be a good predictor for the treatment outcome.

The Prospective Association Between Electronic Device Use Before Bedtime and Academic Attainment in Adolescents.

PURPOSE: To examine longitudinal associations between five commonly used technology devices prior to bedtime and real-life academic outcomes in adolescents. METHODS: A total of 853 adolescents were recruited to a three-year prospective cohort study, with annual assessments. Academic grades/levels for three core subjects (English, Mathematics, and Science) were extracted from school records, and standardized (z-scores) were derived at the end of each academic year. A validated questionnaire was used to determine the frequency of using five types of technology (television viewing, video gaming, mobile telephone use, listening to music, and social networking) before bedtime. RESULTS: After adjustment, English attainment was the subject most affected by prebedtime technology use, where three of five technologies assessed were negatively and prospectively associated (social networking [ß = -.07 and p = .024], video gaming [ß = -.10 and p = .008], and mobile telephone [ß = -.07 and p=.017]). Social networking (ß = -.07and p = .042), television viewing (ß = -.08 and p = .044), and mobile telephones (ß = -.07 and p = .031) were associated with significant impairment in English for girls whereas attainment in boys was most impaired by video gaming (ß = -.12 and p = .014). CONCLUSIONS: The use of electronic devices by adolescents before bedtime may reduce their academic attainment, but apart from video gaming for boys, the negative impact of near bedtime technology use on academic performance is small.