Abstract
Purpose :
The micropulse transscleral cyclophotocoagulation (MP-TSCPC) has been proven to treat refractory glaucomas, mainly with very limited vision. Very scarce information is present regarding results with this relatively new treatment on patients with good vision. The aim of this study is to investigate the short-term efficacy and safety of MP-TSCPC on a consecutive case series of refractory glaucoma cases in eyes with good vision.
Methods :
A retrospective review of consecutive case series of adult patients with refractory glaucoma and BCVA ≥ 20/40 which underwent MP TSCPC in a specialized center in Western Mexico. All consecutive cases with complete clinical information during at least 6 months of follow up were included. A surgical procedure success was defined if the following standard criteria were met: (1) the postoperative OP remained in a range of 5-21 mm Hg and was reduced at least 30% compared to the baseline IOP with or without medication (complete or qualified success), (2) there was no loss of light perception or vision threatening severe complications, and (3) no additional glaucoma surgery was required. Minor and major complications as well as their outcomes were also registered. A p value ≤ 0.05 eas considered statistically significant.
Results :
Fourteen eyes of 14 patients (mean age, 58.5±21.6 years; 8 female, 6 male) were included in the study. All eyes had a logMAR BCVA above 0.4. Mean power and time of MP TSCPC were 2,550 ±208.4 mW and 146.3 ±45.6 seconds, respectively. Preoperatively, the mean intraocular pressure (IOP) was 36.42 ±9.81 mm Hg. Postoperatively, the mean IOP significantly decreased at all follow up points: 24.6±7.9 mm Hg at 1 day (P=0.0004), 14.12±5.9 mm Hg at 7 days (P<0.0001), 13.2±6.5 mm Hg at 1 month (P<0.0001), 14.9±6.2 mm Hg at 3 months (P<0.0001), and 16.3±5.4 mm Hg (P<0.0001) at 6 months. The success rate was 85.7% at 6 months. Two cases required reoperation during the 6 months of follow up. Two cases with prior macular edema had a self-limite recurrence.
Conclusions :
This study provides short-term evidence that MTS-CPC when used in eyes with good vision is a clinically useful procedure that effectively reduces IOP maintaining a very good safety profile.
This is a 2021 ARVO Annual Meeting abstract.