Abstract
Purpose :
To compare the outcomes of micropulse cyclophotocoagulation (MP-CPC) in patients with and without a history of tube shunt surgery.
Methods :
This is a retrospective chart review of patients who underwent MP-CPC from May 2017 to December 2020, comparing those with and without a history of tube shunt surgery. The treatment group is referred to as the tube-group and the control group is referred to as the non-tube group. All forms of glaucoma were included, and the patients were followed for at least 12 months. Success (S) was defined by an intraocular pressure (IOP) of 8-18mmHg, requiring fewer drops than before MP-CPC, vision greater than no light perception (NLP), and requiring no further intervention. If any alternative procedural (i.e. repeat MP-CPC) or surgical intervention was required to control IOP, this would qualify as a failure.
Results :
The tube group (n=21) had an average age of 57.62 ± 10.53, male preponderance (52.4%), and neovascular glaucoma the most common glaucoma diagnosis. 57.1% of the tube group was phakic. This contrasts to the non-tube group (n=41) with average age of 59.68 ± 15.7, female preponderance (53.7%), and primary open angle glaucoma the most common diagnosis (46.3%). Pre-op IOP for the tube group was 28.29 ± 7.68 with the number of pre-op topical glaucoma medications 3.90 ± 0.525; pre-op IOP for the non-tube group was 30.46 ± 10.68 with the number of topical glaucoma medications 3.29 ± 0.74 (P=0.37). Principal data suggests greater success in the tube group than the non-tube group at six months of follow up (IOP of 14.6 versus 15.67; P=0.024). In addition, at 3-, 6-, and 12- month follow ups, there were statistically significant decreases in IOP and the number of medications used for the tube group – 13.5mmHg with 2.67 topical drops, 14.6mmHg with 2.67 topical drops, and 12.33mmHg with 2.50 topical drops. For the 3-, 6-, and 12- month follow ups, the success rate, as defined above, was 33% & 17%, 43% & 14%, and 33% & 7% for the tube group and the non-tube group, respectively. The most common complication was hypotony (as defined by ≤7mmHg) occurring four times in each group.
Conclusions :
This data suggests that MP-CPC is more effective in patients with previous tube shunt surgery compared to those without while maintaining a good safety profile.
This is a 2021 ARVO Annual Meeting abstract.