Long‐term results (&gt;1 year) in 19 dogs treated with MicroPulse transscleral diode cyclophotocoagulation for refractory glaucoma

ObjectiveTo evaluate the long‐term outcome of endoscopic cyclophotocoagulation (ECP) for the treatment of primary and secondary glaucoma in dogs.Animals StudiedRetrospective review of dogs that underwent ECP at two referral centers from 2004 to 2023.ProceduresMedical records of 389 eyes (301 dogs) following ECP were reviewed. Outcomes evaluated included follow‐up time, intraocular pressure (IOP), vision status, additional ECP procedures performed, number of medications, and complications. Patient and surgical variables and their association with IOP control and vision maintenance were evaluated.ResultsMedian follow‐up time was 18 months. IOP remained controlled in 90% and 95% of patients at 1 and 2 years, respectively, following ECP. IOP was controlled long‐term (2 years) in cases with primary (88%) and secondary (99%) glaucoma. Post‐operative vision was maintained in 63% and 49% of eyes at approximately 1 and 2 years, respectively. Median time to vision loss was 6.5 months. Repeat ECP was required in 15.4% of eyes at a median of 19 days post‐operatively. Eyes that underwent more than one ECP surgery had a significantly longer median time to blindness (13.8 months) than those that underwent a single ECP procedure (3.6 months; p = .0003). The median number of anti‐glaucoma medications decreased from three pre‐operatively to one at 1‐ and 2‐year post‐operatively. Complications included corneal ulceration (28%), blinding hypotony (11%), retinal detachment (11%), and hyphema (10%).ConclusionEndolaser cyclophotocoagulation is an effective surgery for maintaining long‐term IOP control and extending vision in canine patients with glaucoma refractory to medical management.

Retrospective evaluation of surgical outcomes in canine patients with primary and secondary glaucoma following diode endoscopic cyclophotocoagulation

Sosnowik,

Webb,

Bras

et al. 2024

MicroPulse™ transscleral cyclophotocoagulation in the equine patient: A case series of four horses

Sturbaum,

Kaiser,

Riesberg

2024

ObjectiveTo describe the clinical application and outcome of MicroPulse™ transscleral cyclophotocoagulation (MP‐TSCPC) treatment in horses with glaucoma.Animals StudiedFour client‐owned horses with primary (n = 2) or secondary (n = 2) glaucoma.MethodsHorses were treated with MP‐TSCPC under standing sedation with a minimum of 30 days of follow‐up (range 30–1241 days). Affected eyes were treated with a 31.3% duty cycle and 3000 mW laser power for a total of 180 s. Data collected included signalment, pre‐ and post‐procedure intraocular pressures (IOPs), laser settings, medications, complications, and repeat therapy.ResultsFour horses (5 eyes) received at least one treatment with MP‐TSCPC. Mean preoperative IOP was 44 mmHg (range 33–49 mmHg). The immediate mean postoperative IOP was 34 mmHg (4 eyes; range 19–55 mmHg). At 1 week, IOP was 38 mmHg (5 eyes; range 21–80 mmHg), at 2 weeks was 40 mmHg (3 eyes, range 17–80 mmHg), at 1 month was 35 mmHg (5 eyes; range 20–50 mmHg), at 3 months was 18 mmHg (2 eyes; range 14–21 mmHg), at 6 months was 35 mmHg (2 eyes; range 30–39 mmHg), and at >300 days was 24 mmHg (3 eyes; range 18–29 mmHg). Complications included corneal ulceration (n = 1 eye), uncontrolled IOP (n = 3 eyes), and need for repeat treatment (n = 2 eyes).ConclusionsMP‐TSCPC used with the above‐described settings was unsuccessful in treating the majority of cases. Future studies should be targeted at primary glaucoma cases and with use of alternative laser settings.

Micropulse transscleral cyclophotocoagulation in canine glaucoma: A retrospective study evaluating sweep velocity

Benitez‐Vera,

Bras,

Montiani‐Ferreira

2024

ObjectiveTo report preliminary results of MP‐TSCP in canine patients with glaucoma while evaluating sweep velocity, treatment efficacy, and safety utilizing standardized surgical parameters.Animal studiedClient‐owned dogs that underwent MP‐TSCP at a veterinary referral hospital.ProcedureMedical records of 19 eyes (14 dogs) treated with MP‐TSCP were reviewed. Eleven eyes were treated with a 10 s/sweep (s) velocity and 8 eyes with a 20 s/s. Laser duty cycle was set at 31.3%, mean laser energy was 2766 mW, and mean duration was 120 s per hemisphere. Minimum post‐operative follow‐up was 6 months. Outcomes of intraocular pressure (IOP), vision status, degree of antiglaucoma medications, and complications were evaluated.ResultsThere was a significantly lower median (IQR) IOP (<25 mmHg) at each timepoint postoperatively compared to IOP pre‐operatively (p < 0.05). The overall success rate for IOP control at 6 months was 84%, 100% for the 10 s/s and 62.5% for the 20 s/s. Vision was preserved in 10/11 (90%) eyes from the 10 s/s group and 4/8 (50%) eyes from the 20 s/s group at 6 months. Average number of glaucoma medications in the 10 s/s group decreased from 4.4 to 1.5 and from 3.3 to 2.5 in the 20 s/s group. Post‐operative complications were mild and resolved within 1 week.ConclusionsMP‐TSCP is a non‐invasive treatment alternative for canine glaucoma. Employing higher energy levels rendered long‐term IOP control while retaining a high safety profile with minimal postoperative complications. There was no statistical difference between a 10 s/s and 20 s/s surgical velocity, both leading to successful surgical outcomes up to 6 months post‐operatively.