Micropulse Cyclophotocoagulation: Initial Results in Refractory Glaucoma

Emanuel, Matthew E.; Grover, Davinder S.; Fellman, Ronald L.; Godfrey, David G.; Smith, Oliver J.; Butler, M. R.; Kornmann, Helen L.; Feuer, William J.; Goyal, Swati

doi:10.1097/ijg.0000000000000715

Cited by 166 publications

(101 citation statements)

References 11 publications

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“…Micropulse CPC (MP-CPC) seems more efficient than UC3 in refractory glaucoma, inducing more than 40% reduction in IOP at 12 months after surgery but reduced efficacy with time. [27] DL-CPC allows for a 44% mean reduction in IOP at 19 months in eyes with higher baseline IOP (36 mmHg). [28] In all previous major studies, the procedure was reported as safe without serious intra-or postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of ultrasonic circular cyclocoagulation with second-generation probe in glaucoma: A retrospective study

et al. 2020

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BackgroundTo assess the efficacy and safety of the second-generation probe of ultrasonic circular cyclocoagulation (UC3) in naive or refractory glaucoma, with a 6-month follow-up. MethodsA retrospective consecutive case-series study included patients having a UC3 procedure with the second-generation probe of the EyeOP1 device, intraocular pressure (IOP) � 21 mmHg and under maximum tolerated medical treatment, with or without previous glaucoma surgery. Surgical success was defined at the 6-month post-operative visit as IOP > 5 and � 21 mmHg with IOP reduction � 20% from baseline, without any reoperation, and visual acuity better than negative light perception. Results100 patients were included and 97 (97.0%; 97 eyes) attended the 6-month follow-up. At 6 months, surgical success was obtained in 48 eyes (49.5%). Intraocular pressure was reduced from a mean ± SD preoperative value of 28.0 ± 5.6 mmHg to 19.3 ± 7.1 mmHg at 6 months (p<0.0001). The proportion of eyes requiring oral acetazolamide decreased from 57.0% to 30.0% between baseline and 6 months after surgery (p = 0.0007). We observed 15 (15.0%) cases of postsurgical macular edema, 8 (8.0%) of hypotony, and 20 (20.0%) of visual acuity loss > 2 Snellen lines. Postsurgical macular edema was associated with a history of epiretinal membranes, uveitis or retinal detachment. Risk factors for hypotony were a history of diabetes or trabeculectomy. ConclusionsThe second-generation UC3 probe significantly reduced IOP in eyes with naive and refractory glaucoma but severe post-operative complications were often observed. Further Citation: Chamard C, Daien V, Han H, Greenfield DS, Villain M (2020) Efficacy and safety of ultrasonic circular cyclocoagulation with secondgeneration probe in glaucoma: A retrospective study. PLoS ONE 15(1): e0227389. https://doi.org/ 10.studies are needed to better identify responders and decrease the high risk for complications associated with the procedure. MethodsThis study followed the STROBE checklist for reporting observational study findings. [22] Design Retrospective consecutive case-series study with 6-month follow-up. Examinations were performed before the procedure and 1 week, 1, 3, and 6 months afterwards. Preoperative hypotensive medications remained unchanged during the first month except for cases of hypotony, then adjusted if necesary during follow-up. Re-treatment was proposed after a minimum of 3 months if surgical success was not achieved. Patients were retreated with a second UC3 procedure, DL-CPC (diode laser cyclophotocoagulation) or trabeculectomy when IOP target was not reached, according to glaucoma stage, prior treatments and visual potential.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of ultrasonic circular cyclocoagulation with second-generation probe in glaucoma: A retrospective study

et al. 2020

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“… 1 Although it has been suggested to have a safer profile in comparison with traditional transcleral cyclophotocoagulation (TCP), the following complications have been described with MP-TCP: hypotony, intraocular pressure (IOP) spike, prolonged anterior chamber inflammation, macular edema, corneal edema, phtisis bulbi, and transient hyphema in cases with neovascular glaucoma. 1 , 2 , 3 , 4 , 5 , 6 The aim of this case report is to present two cases of severe neurotrophic keratopathy (NK) after MP-TCP. To our knowledge, these post-MP-TCP complications have not been previously described in the literature.…”

Section: Introductionmentioning

confidence: 99%

Neurotrophic keratitis after micropulse transscleral diode laser cyclophotocoagulation

Pérez

Han

Rose‐Nussbaumer

et al. 2019

American Journal of Ophthalmology Case Reports

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Purpose To report two cases of neurotrophic keratitis (NK) after micropulse transscleral cyclophotocoagulation (MP-TCP). Observations Two patients with predisposing factors for decreased corneal sensation developed NK 1 month after MP-TCP. Both patients did not heal with initial treatment with topical antibiotic and preservative free artificial tears. One patient required use of a bandage contact lens and the other patient required tarsorrhaphy. Both eyes experienced recurrence of NK. Conclusions and importance NK can be triggered after MP-TCP in patients with underlying predisposing factors for decreased corneal sensation. This uncommon but vision-threatening complication should be discussed preoperatively with high-risk patients as a possible adverse event after MP-TCP and followed closely postoperatively.

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“…The authors indicate that eye size is the most useful factor in determining the duration of an illness. Chronic glaucoma is the only reason for the increase in the eyeball in size and the development of buphthalmia [8,9,10,11]. In almost all cases, the enlarged eye is irreparably blind.…”

Section: Introductionmentioning

confidence: 99%

“…A thorough ophthalmic examination should help to determine if the case is primary or secondary. If the patient has a lens dislocation, this will affect on the prognosis and choice of treatment, lens extraction will be necessary for successful state management [8,9]. The diagnosis of lens dislocation is based on the study of the anterior segment, for its visualization using a slit lamp, in addition, visualization of the lens using ultrasound examination of the eye is possible [8,10,11].…”

Section: Introductionmentioning

confidence: 99%

“…In the absence of relief of an acute attack of glaucoma during the day, as a rule, irreversible loss of vision occurs due to damage to the retina, compression of the optic nerve and, subsequently, its atrophy. Both primary and secondary glaucoma is difficult to diagnose and requires an individual approach to the choice of therapeutic tactics, which determined the relevance of our work [8,9,10,11].…”

Section: Introductionmentioning

confidence: 99%

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Clinical case of the secondary glaucoma treatment in a dog by transscleral cyclophotocoagulation

Kartashov

Oboeva

Kartashova³

et al. 2019

E3S Web Conf.

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Glaucoma is a common disease in animals, often leading to blindness. Nowadays, there are several treatments for glaucoma. One of promising technique is transscleral cyclophotocoagulation. This article presents a clinical case of treating a dog with bilateral secondary glaucoma complicated by optic atrophy and blindness of the right eye. Thanks to the combination of drug therapy and surgical treatment, a steady decrease in intraocular pressure was achieved.

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Micropulse Cyclophotocoagulation: Initial Results in Refractory Glaucoma

Cited by 166 publications

References 11 publications

Efficacy and safety of ultrasonic circular cyclocoagulation with second-generation probe in glaucoma: A retrospective study

Efficacy and safety of ultrasonic circular cyclocoagulation with second-generation probe in glaucoma: A retrospective study

Neurotrophic keratitis after micropulse transscleral diode laser cyclophotocoagulation

Clinical case of the secondary glaucoma treatment in a dog by transscleral cyclophotocoagulation

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