Outcome Of MicroPulse Transscleral Photocoagulation In Different Types Of Glaucoma

Purpose: To evaluate the safety and efficacy of MicroPulse transscleral cyclophotocoagulation (µP-TSCPC) up to 24-months follow-up using a standardized fixed protocol in patients with various types of glaucoma.

Methods: Prospective, nonrandomized, non-comparative interventional case series of µP-TSCPC performed by a single glaucoma surgeon at tertiary hospitals between May 2017 and May 2019.

Results: A total of 71 eyes of 68 patients (39 males, 29 females) aged 60.0 years (13-89 years) were treated with µP-TSCPC. The most common diagnosis was neovascular glaucoma. The safety index of corrected distance visual acuity (CDVA) was 1.0, i.e. there was no significant change in CDVA postoperatively compared to baseline CDVA. The median baseline IOP was 35.0 mmHg (21.0-70.0 mmHg), which was reduced to 16 mmHg (8-32 mmHg) at 12 months/last follow-up postoperatively (p<0.001, Wilcoxon signed-rank test). The median reduction in IOP was 52% (0.0-89%) at 12 months/last follow-up postoperatively compared to baseline. The median number of medications was 5 (3-5) at baseline compared to 4 (2-4) at 12 months/last follow-up postoperatively (p<0.001, Wilcoxon signed-rank test). The percent of eyes treated with systemic glaucoma medication was 62% (44) at baseline compared to 0% (0) at 12 months/last follow-up postoperatively. The postoperative surgical success of 90%, 91.4%, and 95.7% at 2 weeks, 3 months, and 6 months respectively then remains unchanged. No significant adverse events or complications were observed.

Conclusion: µP-TSCPC demonstrated good efficacy and safety profiles with minimal vision-threatening complications in treating a variety of glaucoma types.