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Clarisa Del Hierro, Daniela Alvarez Ascencio, Carolina Prado Larrea, Jesús Jiménez Román; Micropulse Transscleral Cyclophotocoagulation in Refractory Glaucoma. 6 month follow-up.. Invest. Ophthalmol. Vis. Sci. 2019;60(9):700.
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To describe the efficacy of micropulse transscleral cyclophotocoagulation (MP-CPC) in Hispanic patients with refractive glaucoma with a 6 month follow- up.
Prospective case series. Thirty six eyes of 27 patients with refractory glaucoma were included. All eyes underwent a single session of MP-CPC with the Iridex IQ 532 Micropulse laser with the following settings: 2000 mW for 90-120 seconds for each hemisphere depending on the severity of each case. All eyes completed a 6 month follow-up. Main outcome measures were Intraocular Pressure (IOP) and number of glaucoma medications at baseline, day 1, week 1, month 3 and 6 postoperatively. Secondary outcome measures were visual acuity, anterior chamber inflammation, and incidence of adverse events.
Mean age was 47 years (±24.8 SD). Mean IOP at baseline (BL) was 22 mmHg (±6.2), with a reduction to 16.2 mmHg (±7.0) at month 1, 18.2 mmHg (±8.6) at month 3, and 14.5 mmHg (±2.7) at 6 months. Mean number of hipotensive medications at BL was 3.8 (±0.5), and 2.4(±1.1), 2.7(±1.3) and 2.8 (±1.3) at 1, 3 and 6 months postoperatively. Total IOP reduction at month 6 was 29.5% (CI 2.63-11.2, p=0.0002), total reduction of hypotensive medications at 6 month follow-up was 26% (CI 2.636-11.2, p=0.0097). Main adverse events reported were anterior chamber inflammation for less than 1 month in 47% eyes, subconjunctival hemorrhage in 32.3% eyes, corneal abrasion 23.5% eyes, failure of procedure 11.4% and wipe out in 1 eye.
MP-CPC is an effective procedure in lowering IOP and decreasing the need for ocular antihypertensive medications in patients with refractory glaucoma. Our results in a Hispanic population concur with previous reports, regarding MP-CPC as a reasonable treatment alternative in these patients, and a potentially better option to traditional CPC. Nonetheless, longer follow-up is required to standardize treatment settings and analyze long-term results.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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