Micropulse Transscleral Cyclophotocoagulation as Primary Surgical Treatment for Primary Open Angle Glaucoma in Taiwan during the COVID-19 Pandemic

Abstract

Glaucoma is the leading cause of irreversible blindness worldwide, with primary open angle glaucoma (POAG) accounting for the greatest number of total glaucoma cases. This study aimed to evaluate the efficacy and safety of micropulse transscleral cyclophotocoagulation (MP-TSCPC) as a primary procedure in POAG during the COVID-19 pandemic. We retrospectively analyzed 60 eyes of 52 patients, who were diagnosed with mild-to-end-stage POAG without previous glaucoma surgery and received MP-TSCPC between 1 January 2020 and 31 August 2020. The mean preoperative intraocular pressure (IOP) significantly decreased from 27.8 mm Hg to 19.8, 20.1, 20.3, 20.4, and 20.2 mm Hg at 1, 3, 6, 9, and 12 months, respectively (all p < 0.05). The mean number of IOP-lowering medications used significantly decreased from 3.3 at the baseline to 1.6, 1.8, 1.8, 1.9, and 1.9 at 1, 3, 6, 9, and 12 months, respectively (all p < 0.001). Total withdrawal of antiglaucoma medications was fulfilled in five patients. The main outcome was achieved in 81.7% at postoperative month 12. The most common adverse effect was transient mydriasis (28.3%). No major complications were encountered. MP-TSCPC seems to be an effective and safe treatment to reduce IOP and the medication burden with minimal vision-threatening complications in mild-to-end-stage POAG patients without previous glaucoma surgery.

Prevalence of blood born viral infections among glaucoma patients in south-east, Nigeria

“…19 Glaucoma remains the leading cause of irreversible blindness worldwide, with primary open angle glaucoma accounting for the greatest number of total glaucoma cases. 20 The principal findings of this study was that the overall prevalence of HBV, HCV and HIV was 2.41%, 1.45% and 3.22 respectively. Additionally, the prevalence of HBV was significantly higher in males compared to female counterparts.…”

Assessment of Pain in Glaucoma Patients Undergoing Micropulse Transscleral Laser Therapy

“…MPTLT-related pain has been reported in the literature. Table 4 summarizes the study characteristics and the pain outcomes from five previous studies [ 3 , 4 , 12 , 13 , 14 ]. Tan et al and Chang et al demonstrated considerably lower prevalence of pain than Yelenskiy et al and our study, whereas Preda et al and Popa et al reported mean visual analog scale values that were comparable to our mean NRS value.…”

“…Despite receiving local anesthesia, some patients who undergo MPTLT report pain that might affect their quality of life and ability to perform activities of daily living. Few studies have evaluated pain due to MPTLT, and most have focused only on pain during the procedure [ 3 , 4 , 12 , 13 , 14 ]. This study aimed to assess the pain during the procedure as well as the overnight pain after MPTLT under retrobulbar anesthesia and explore the factors associated with the two types of pain.…”

Scleral burn and perforation following transscleral cyclophotocoagulation

“… 1 , 2 It has recently gained more popularity, even for milder glaucoma with good visual potential. 3 , 4 It is a short, effective, and easy-to-apply procedure; however, there are several possible complications, including pupillary distortion, disturbed accommodation, conjunctival burn, uveitis, hyphema, cystoid macular edema, chronic hypotony, retinal detachment, and phthisis bulbi. 5 , 6 , 7 Scleral perforation is an uncommon complication of transscleral CPC, with few cases reported in the literature.…”