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Micropulse transscleral cyclophotocoagulation: initial results using a reduced energy protocol in refractory glaucoma
Niten Vig1, Sally Ameen2, Philip Bloom2
1Department of Glaucoma, Western Eye Hospital, Imperial College Healthcare NHS Trust, London, UK. n.vig@nhs.net.
Summary
Micropulse transscleral cyclophotocoagulation (MP-TSCPC) effectively lowered intraocular pressure in glaucoma patients. This reduced-energy treatment showed significant IOP reduction and decreased medication needs over six months without serious complications.
Area of Science:
- Ophthalmology
- Glaucoma Management
- Medical Technology
Background:
- Glaucoma and ocular hypertension require effective intraocular pressure (IOP) management.
- Previous treatments like filtration surgery or continuous wave diode laser may not suffice for all patients.
- Micropulse transscleral cyclophotocoagulation (MP-TSCPC) offers a less invasive approach to IOP control.
Purpose of the Study:
- To evaluate the 6-month safety and efficacy of MP-TSCPC using a reduced energy protocol.
- To assess IOP reduction and medication requirements in patients with uncontrolled glaucoma or ocular hypertension.
- To determine the complication profile of this modified MP-TSCPC protocol.
Main Methods:
- Retrospective analysis of 29 patients undergoing MP-TSCPC between January and April 2018.
- Application of MP-TSCPC with a reduced energy protocol (up to 90s, 2000 mW/cm², 31.3% duty cycle).
- Inclusion of patients with primary open-angle glaucoma and those previously treated with intraocular surgery or laser.
Main Results:
- Significant IOP reduction from a mean of 26.2 mmHg pre-treatment to 18.19 mmHg at 6 months (30.6% decrease, p<0.05).
- Mean topical glaucoma medications decreased from 3.31 to 2.90 at 6 months (p<0.05).
- Success rates were 75.9% at 1 month, 79.3% at 3 months, and 58.6% at 6 months, with no adverse effects on visual acuity or retinal thickness.
Conclusions:
- Reduced-duration MP-TSCPC is effective in lowering IOP for diverse glaucoma patients refractory to prior treatments.
- The protocol demonstrates a favorable safety profile with no significant complications at 6 months.
- Further research is warranted to establish long-term efficacy and optimize MP-TSCPC settings.
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