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Jun Hui Lee, Behzad Amoozgar, Shan C Lin, Sriranjani Padmanabhan; Short Term Outcomes of Micropulse Transscleral Cyclophotocoagulation in an Urban Public Hospital. Invest. Ophthalmol. Vis. Sci. 2018;59(9):6108.
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So far, clinical studies on micropulse transscleral cyclophotocoagulation (MP-TSCPC) have been conducted at university hospitals or private clinics. We performed a retrospective, observational clinical study to determine the short-term outcome of MP-TSCPC in a population served by a public, urban hospital.
Thirty-eight consecutive eyes with glaucoma that underwent MP-TSCPC at Zuckerberg San Francisco General Hospital (ZSFGH) between October of 2015 and April of 2017 were included. Laser settings for MP-TSCPC was tailored to each case and varied between 1900 - 2000 milliWatts, duty cycle of 31.33%, with 2-4 80 second cycles delivered over 180 degrees. Patients were followed for at least 3 months. Preoperative and postoperative IOP and the number of glaucoma medications were compared via Wilcoxon signed rank test. Rate of success, defined as IOP of less than 21 mmHg or greater than 20% deduction from the baseline IOP without requiring additional glaucoma surgery at 3 month, is also reported.
The mean preoperative IOP was 30.34 +/- 11.27 mmHg. The mean postoperative IOP was 17.06 +/- 8.70 mmHg at 1 month, and 20.69 +/- 11.42 mmHg at 3 months (p<0.001 at both points). The mean number of glaucoma medication used preoperatively was 3.18 +/- 1.33. Postoperatively, the mean number of medication was 3.21 +/- 1.36 at 1 month, and 2.61 +/- 1.58 at 3 months (p>0.05 at both points). The rate of success at 3 months was 63.16%. One patient had postoperative complication of macular edema. There was no significant loss of mean visual acuity.
When used in the urban county hospital setting, the MP-TSCPC significantly lowered the IOP at 3 months with moderately high success rate, though the success rate is lower than reported for other practice settings. The rate of complication was low and there was no significant loss of vision. There was no reduction in number of glaucoma medications. Given its safety profile and significant short-term effect, MP-TSCPC may be a good candidate procedure to lower IOP in this clinical setting. Further studies to examine the long-term outcomes and cost-effectiveness of MP-TSCPC in county hospital setting are warranted.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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