July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Three-Year Retrospective Study of Treatment with Micropulse Cyclophotocoagulation as a Primary Procedure for Neovascular Glaucoma
Author Affiliations & Notes
  • Brett Breshears
    Midwestern University, Batavia, Illinois, United States
  • Thomas D Patrianakos
    John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois, United States
  • Michael Giovingo
    John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois, United States
  • Footnotes
    Commercial Relationships   Brett Breshears, None; Thomas Patrianakos, None; Michael Giovingo, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 704. doi:
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      Brett Breshears, Thomas D Patrianakos, Michael Giovingo; Three-Year Retrospective Study of Treatment with Micropulse Cyclophotocoagulation as a Primary Procedure for Neovascular Glaucoma. Invest. Ophthalmol. Vis. Sci. 2019;60(9):704.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Micropulse cyclophotocoagulation (MP-CPC) is a new procedure for lowering intraocular pressure. It offers a lower inflammatory alternative to continuous-wave cyclophotocoagulation (CW-CPC) which lowers intraocular pressure (IOP) by thermally destroying the ciliary body. MP-CPC achieves less cellular damage by chopping up the energy being delivered so that there is not enough time to travel to surrounding tissues. The exact mechanism of MP-CPC is unclear. The favorable efficacy and side effect profile of MP-CPC has been well studied in primary open angle glaucoma (POAG) but there is much less data available looking into the safety and efficacy in secondary glaucomas; especially neovascular glaucoma (NVG). In this study, we retrospectively analyze the efficacy and safety of MP-CPC as a primary procedure in the treatment of NVG in an inner city hospital setting. Our primary outcomes are intraocular pressure (IOP), repeat IOP-lowering procedures, and adverse events.

Methods : A retrospective chart review was performed following 15 patients at Stroger Hospital of Cook County (Chicago,IL) from 2015 to 2018 with uncontrolled NVG that underwent a MP-CPC as a primary procedure. MP-CPC was determined necessary by a failed IOP goal on maximally tolerated medical treatment. The IOP values were recorded before the procedure and at 1 month, 3 months, 6 months, and 1-year post procedure. Confidence intervals (95%) were calculated for each interval. An unequal variance two-tailed t-test was conducted for each interval after the procedure and compared to the pre-op value. Adverse events and the need for a repeat IOP-lowering procedure were also recorded.

Results : MP-CPC adequately lowered IOP in 8 out of 15 patients (Table 1). A repeat MP-CPC procedure was performed in 5 out of 7 patients with uncontrolled IOP (Table 2). IOP was deemed well-controlled (IOP <17mmHg, >6mmHg) in 3 out of these 5 patients. No adverse events were found in any patient with a primary or repeat MP-CPC.

Conclusions : MP-CPC is a procedure that can successfully lower IOP as a primary procedure in NVG patients. Although an eventual repeat IOP lowering procedure may be necessary, the efficacy and safety of a repeat procedure makes it a very useful tool in the treatment of glaucoma.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

 

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