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Fahad H. Khan, Kevin Pikey, Rohit Krishna; The Micropulse Cyclophotocoagulation technique can be a safe and effective treatment for patients with refractory glaucoma.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4992.
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Patients with refractory glaucoma can be a very difficult group to manage. The cyclophotocoagulation technique is widely used to lower intraocular pressures (IOP) in these patients but can carry serious risks and complications. A newer device iteration called Micropulse Cyclophotocoagulation (MP-CPC) is now available that can deliver less total energy to the eye. We hypothesize that the MP-CPC can be used in patients with refractory glaucoma as a safe and effective treatment to reduce IOP. We performed a retrospective observational clinical study in patients with refractory glaucoma treated with the MP-CPC technique to determine the amount of IOP reduction and document any complications.
Patients with refractory glaucoma who never had previous cyclodestructive procedures were considered. Those who underwent a MP-CPC procedure were followed for 6 consecutive months to document any complications and quantify reduction from baseline IOP. A total of 30 patients, aged 63-92 years old, with different types of refractory glaucoma were evaluated by glaucoma specialists over 6 months. The results were recorded and statistical analysis using a two-tailed t test was done to quantify IOP reduction and note any complications.
There was a significant reduction from baseline IOP of 9.06 +/- 8.32 mmHg at post-op day 1, of 10.1 +/- 6.67 mmHg at 1 month, and of 11.06 +/- 9.69 mmHg at 6 months. Statistical analysis showed a reduction of 35%, 39%, and 43% at post-op day 1 (P <0.03), at 1 month (P<<0.01), and at 6 months (P = 0.133). Although the reduction was not statistically significant at 6 months for the total aggregate, for Primary Open Angle Glaucoma (POAG) patients, there was an average of 70% reduction of IOP at 6 months (P <0.05). Only minor complications such as conjunctival injection and mild anterior chamber inflammation were noted.
Our results are consistent with the hypothesis that the MP-CPC is a safe and effective treatment for refractory glaucoma. Most patients sustained a clinically significant decrease in IOP at post-op day one, at 1 month, and the POAG patients at 6 months after the procedure. Only minor side effects were noted such as conjunctival injection and anterior chamber inflammation. Although further research is needed, preliminary studies show that the MP-CPC can be a safe and effective treatment for refractory glaucoma.
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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