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Alice Williams, Marlene Moster, Kamran Rahmatnejad, Michael Reynolds, Teresa Horan, Michael Waisbourd; Clinical Efficacy and Safety Profile of Micropulse Transscleral Cyclophotocoagulation in Advanced Glaucoma. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4996.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the clinical efficacy and safety profile of micropulse transscleral cyclophotocoagulation (MP-TSCPC, IRIDEX IQ810 Laser Systems, CA) in patients with glaucoma.
Patients with advanced glaucoma who underwent MP-TSCPC at the Wills Eye Hospital from 3/23/2014 to 6/23/2016 and who had at least 3 months of follow-up were included in this retrospective chart review. Laser settings were 2000mW of 810nm infrared diode laser with a duty cycle of 31.3%, which translated to 0.5 milliseconds of "on time" and 1.1 milliseconds of "off time". The laser was delivered over 360 degrees for 120-320 seconds. Treatment success was defined as an intraocular pressure (IOP) of 6-21 mmHg or a reduction of IOP by 20%. Failure was defined as an inability to meet the criteria for success, need for re-treatment > 3 times, or need for incisional glaucoma surgery. Outcomes were assessed at 3 months, 6 months, and the last available follow-up visit for those followed longer than 6 months.
A total of 78 patients were included in the study with mean follow-up time of 7.5 ±4.5 months. A total of 10 patients underwent no more than two repeat MP-TSCPCs during the follow-up period. Treatment success rates were 85% at 3 months, 76% at 6 months and 57% at last follow-up. The IOP was reduced by an average of 50% at the last follow-up and the mean number of IOP lowering medications was reduced from 2.2 at baseline to 1.6 at last follow-up. Complications of MP-TSCPC included 5 patients with hypotony (6%), 20 patients with prolonged anterior chamber inflammation (1+ cell or flare for >3 months, 26%) and 10 patients with a loss of 2 or more lines of Snellen visual acuity (13%).
The MP-TSCPC treatment has a high rate of success through 6 months of follow-up in this cohort of patients with advanced glaucoma and a high rate of ocular co-morbidities. Visually significant complications occurred in 13% of patients. Further research is needed to compare the clinical efficacy and safety profile of MP-TSCPC to continuous wave transscleral diode cyclophotocoagulation.
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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