June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
The effects of micropulse transscleral cyclophotocoagulation versus traditional transscleral cyclophotocoagulation diode on intraocular pressure in primary open angle glaucoma
Author Affiliations & Notes
  • Krishna Patel
    John H Stroger Jr Hospital of Cook County, Lombard, Illinois, United States
  • Nathaniel Gelinas
    Midwestern University, Downers Grove, Illinois, United States
  • Hammad Rafay
    Chicago Medical School, North Chicago, Illinois, United States
  • thomas patrianakos
    John H Stroger Jr Hospital of Cook County, Lombard, Illinois, United States
  • Michael Giovingo
    John H Stroger Jr Hospital of Cook County, Lombard, Illinois, United States
  • Footnotes
    Commercial Relationships   Krishna Patel, None; Nathaniel Gelinas, None; Hammad Rafay, None; thomas patrianakos, None; Michael Giovingo, None
  • Footnotes
    Support  Illinois Society for the Prevention of Blindness
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 4991. doi:
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      Krishna Patel, Nathaniel Gelinas, Hammad Rafay, thomas patrianakos, Michael Giovingo; The effects of micropulse transscleral cyclophotocoagulation versus traditional transscleral cyclophotocoagulation diode on intraocular pressure in primary open angle glaucoma. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4991.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Micropulse transscleral cyclophotocoagulation (MP-TSCPC, IRIDEX IQ810 Systems, CA) is a novel technology used for glaucoma refractory to medical therapy. Prior to the advent of MP-TSCPC, a traditional transscleral cyclophotocoagulation (TS-CPC, IRIDEX IQ810 Systems, CA) was used for similar cases of refractory glaucoma. However, as MP-TSCPC is a new technology, there are limited studies regarding its role in the treatment of glaucoma. The purpose of this study is to compare the intraocular pressure (IOP) lowering effects of MP-TSCPC with the effects of TS-CPC in patients with primary open angle glaucoma (POAG).

Methods : A retrospective chart review was done to determine the IOP reducing effects of MP- TSCPC and TS-CPC in patients with refractory glaucoma seen at Cook County Hospital, Chicago IL. The charts of 68 patients with POAG who underwent MP-TSCPC and 36 patients with POAG who underwent TS-CPC were retrospectively reviewed. MP- TSCPC settings included 2W of 810 nm on micropulse mode (duty cycle 31.3%) delivered 160-200 seconds over 360 degrees sparing the 3 and 9 o’clock positions. TS-CPC settings included 1.25-2.81 W with 11-35 spots placed 180-360 degrees also sparing the 3 and 9 o’clock position. Data was analyzed to compare IOP changes at one month, three months, and six months.

Results : The mean reduction of IOP in patients who underwent treatment with MP-TSCPC were 39.76% (n=60) at post-procedural month one, 40.33 % (n=35) at post-procedural month three, and 8.71% (n=15) at post-procedural month six. The mean reduction of IOP in patients who underwent treatment with TS-CPC were 52.73% (n=35) at post-procedural month one, 43.19% (n= 34) at post-procedural month three, and 37.07% (n=31) at post-procedural month six. P values are 0.048 at one month, 0.71 at three months, and 0.013 at six months.

Conclusions : Short term results show TS-CPC is more effective in reducing IOP than MP-TSCPC in patients with POAG. However, MP-TSCPC does also have a substantial IOP reducing effect in patients with POAG, and can be used in patients with refractory glaucoma. As MP- TSCPC is a novel technology with limited use thus far, this information can help guide physicians using the technology. Prospective clinical trials and long-term studies should be done to confirm the effect of MP-TSCPC on IOP.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

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