Abstract
Purpose :
MicroPulse transscleral diode laser cyclophotocoagulation (MP-TSCPC) delivers a series of repetitive short pulses of energy with rest periods in between pulses which is different from the traditional CPC. This study is to evaluate the efficacy and safety of MP-TSCPC in the treatment of refractory glaucoma.
Methods :
This is a prospective interventional case series study. Patients with refractory glaucoma who underwent MP-TSCPC from August to November 2016 at Doheny Eye Center UCLA were included in this study. Laser settings were 2000 mW of 810 nm infrared diode laser set on MicroPulse P3 Glaucoma Device (Iridex, Mountain View, CA, USA). The laser was delivered over 360° for 180 s. 90 s for each hemisphere. The duty cycle was 31.3 %, which translated to 0.5 ms of "on time" and 1.1 ms of "off time." Visual acuity (VA) and intraocular pressure (IOP) before the surgery and at different time point after the surgery were documented. The inflammation in the anterior chamber and the complications were also recorded.
Results :
Twenty eyes of twenty patients (11 male and 9 female) underwent MP-TSCPC were enrolled in this study. The mean age of patients was 69.9 +/- 14.1 years. The mean follow-up period was 58 +/- 42 days. The mean intraocular pressure (IOP) before MP-TSCPC was 28.9 +/- 7.4 mmHg. Mean IOP decreased to 21.9 +/- 9.1 mmHg at 1 day (P=0.005), 18.7 +/- 7.1 mmHg at 1 week (P<0.001), 16.4 +/- 5.0 mmHg at 1 month (P<0.001). At the last visit, VA was equal or better than the pre-surgery in 17 patients (85%); three patients decreased VA in average 1.3 lines of vision. Except mild inflammation in three patients at first day post operation, no inflammation was recorded during follow-up period. No complications were identified.
Conclusions :
The novel MP-TSCPC laser is a safe and effective method of lowering IOP after a short follow-up period in patients with refractory glaucoma. Further long-term evaluation is warranted.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.