Treatment outcomes of micropulse transscleral cyclophotocoagulation in advanced glaucoma

Abstract

Glaucoma is the leading cause of irreversible blindness worldwide. The goal of this study was to describe our experience with the novel micropulse transscleral cyclophotocoagulation (MP-TSCPC; IRIDEX IQ810 Laser Systems, CA) in patients with advanced glaucoma. Patients with advanced glaucoma who underwent MP-TSCPC were included in our study. Laser settings were 2000 mW of 810 nm infrared diode laser set on micropulse delivery mode. The laser was delivered over 360° for 100-240 s. The duty cycle was 31.3 %, which translated to 0.5 ms of "on time" and 1.1 ms of "off time." Surgical success was defined as an intraocular pressure (IOP) of 6-21 mmHg or a reduction of IOP by 20 % at the last follow-up visit. Failure was defined as an inability to meet the criteria for success or a need for incisional glaucoma surgery. Nineteen patients underwent MP-TSCPC with mean follow-up of 60.3 days. Mean IOP dropped from 37.9 mmHg preoperatively to 22.7 mmHg at last follow-up, representing a 40.1 % decrease. The success rate for initial treatment was 73.7 % (n = 14). Three patients underwent a second treatment, increasing the overall success rate to 89.5 % (n = 17). Four patients gained one line of vision, and four patients lost one line of vision. The novel MP-TSCPC laser had a high rate of surgical success after a short follow-up period in patients with advanced glaucoma. Further long-term evaluation and comparison to the traditional transscleral cyclophotocoagulation are warranted.

Choroidal thickness increase after micropulse transscleral cyclophotocoagulation

“…Our experience with MP-TSCPC showed a 33.12% reduction in IOP at last follow-up, a rate that is similar to other published reports on MP-TSCPC [ 15 ]. There were no cases of hypotony, phthisis bulbi, or ocular prolonged inflammation.…”

Practice Preferences for Glaucoma Surgery: A Survey of the American Glaucoma Society

“…Early studies of MP-TSCPC suggest success rates over 70%, but long-term results are not available for this novel procedure. 24,25 In our survey, surgeons indicated that they used CPC of any method most frequently for eyes with prior SB, neovascular glaucoma, and prior PKP. Future surveys can assess whether the availability of ECP and MP-TSCPC will shift the use of CPC toward more low-risk eyes.…”

MicroPulse™transscleral cyclophotocoagulation in the treatment of canine glaucoma: Preliminary results (12 dogs)

“…MicroPulse™ transscleral cyclophotocoagulation (MP‐TSCPC) offers a safe and effective alternative to traditional TSCPC in humans . With this system, the laser beam is “chopped” into a train of repeated short, microsecond, “on” pulses followed by longer‐duration “off” intervals.…”