Associations between urinary biomarkers of phthalates and phthalate alternatives and female sexual function in a North American cohort.

Pediatric glaucoma is one of the most challenging ocular diseases to treat. In particular, glaucoma associated with congenital anterior-segment structural abnormalities or glaucoma that develops secondary to other eye diseases such as cataracts, retinal detachment, or retinopathy of prematurity presents additional anatomic and pathophysiologic complexities, making the development of appropriate treatment strategies extremely difficult []. Even if a temporary reduction in intraocular pressure (IOP) is achieved, elevated IOP can recur during long-term follow-up, often requiring multiple surgical interventions. Conventional treatments such as trabeculotomy, trabeculectomy, and various device implantation procedures (Ahmed valve, New World Medical; Baerveldt tube, Johnson and Johnson Surgical Vision) can suppress the IOP to a certain level in the short term [–], but they often have limitations in maintaining long-term visual function owing to postoperative complications and the strong scar formation response characteristic of children. Thus, when treating pediatric glaucoma, 1 surgical procedure or treatment modality is insufficient, and a long-term, multifaceted, staged treatment plan is required. The establishment of a treatment method that can safely maintain stable visual acuity (VA) and the visual field over the long term remains an important challenge. In recent years, micropulse transscleral cyclophotocoagulation (MP-CPC) using micropulse waves has emerged as a new treatment option []. Conventional continuous wave transscleral cyclophotocoagulation (CW-CPC) has demonstrated high efficacy in reducing IOP; however, because it carries a high risk of severe complications such as significant tissue damage, vision loss, and ocular atrophy, it is typically reserved for endstage cases or those unresponsive to other treatments. In contrast, MP-CPC delivers energy in intermittent pulses, thereby minimizing thermal damage to the ciliary body while suppressing aqueous humor production and promoting uveoscleral outflow to reduce the IOP. As a result, this minimally invasive treatment, which minimizes postoperative inflammation and pain while preserving visual function and ocular morphology, has been primarily applied to adult glaucoma [–]. Reports on the efficacy and safety of MP-CPC in pediatric glaucoma remain insufficient [–]. Considering the anatomic and physiologic characteristics unique to children, it is necessary to evaluate risks specific to this population, including postoperative inflammatory responses, scar formation, the effects of multiple procedures on long-term outcomes, and the impact on ocular growth.