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Krishna Patel, SHERIF DAWOOD, Hammad Rafay, Thomas Patrianakos, Michael Giovingo; Results of a Novel Glaucoma Treatment: Micropulse Transcleral Cyclophotocoagulation Diode Laser. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6484.
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© ARVO (1962-2015); The Authors (2016-present)
Micropulse transcleral cyclophotocoagulation (MP-TSCPC, IRIDEX IQ810 Systems, CA) is a novel technology used for glaucoma refractory to medical therapy. However, as this is a new technology, there are limited studies of its place in the treatment of glaucoma. The purpose of this study is to describe the safety, efficacy, and complications of MP-TSCPC technology in patient with various types of glaucoma refractory to medical therapy, and determine the optimal timing to perform MP-TSCPC for treatment of glaucoma.
A retrospective chart review was done to determine the effects of MP- TSCPC on intraocular pressure (IOP) in 24 eyes of 23 patients seen at Cook County Hospital, Chicago IL. MP- TSCPC settings included 2000 mW of 810 nm on micropulse mode (duty cycle 31.3%) delivered160-200 seconds over 360 degrees. Data was analyzed to compare IOP changes in patients with primary open angle glaucoma (POAG), secondary open angle glaucoma (SOAG), neovascular glaucoma (NVG), combined mechanism glaucoma (CMG) and juvenile open angleglaucoma (JOAG). IOP change in patients with and without prior surgery was also compared to determine the optimal time and group to perform MP-TSCPC. Success was defined as IOP between 5- 21 mmHg or a reduction of IOP by 20% from baseline at time of last followup.
The mean reduction of IOP in patients who underwent treatment with MP-TSCPC were 33% (n=11), 57% (n=23) and 60% (n=11) on post-procedure day one, week one, and month one respectively. Success rates were 100% in POAG (n=10), 62.5% in SOAG (n=8), 100% in JOAG (n=3), 100% in NVG (n=2), and 100% in CMG (n=1) at time of last follow up visit. At post-procedure week one, IOP decrease in patients with SLT only, previous incisional surgery, and neither was 47.27% (n=2), 61.91% (n=8) and 55.41% (n=13) respectively. Complicationsinclude hyphema (n=1), retrobulbar hemorrhage (n=1), and subconjunctival hemorrhage (n=2).
MP- TSCPC is effective in lowering IOP in various types of glaucoma. Short term results of the procedure prove it to be safe and well tolerated, and suggests that MP-TSCPC can be used for treatment of various types of glaucoma before or after incisional surgery. As MP- TSCPC is a novel technology with limited use thus far, this information can help guide physicians using the technology. If confirmed by prospective clinical trials, MP-TSCPC may play a key role in treatment for glaucoma.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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