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Histologic Changes Following Continuous Wave and Micropulse Transscleral Cyclophotocoagulation: A Randomized

Kareem Moussa1, Max Feinstein1, Melike Pekmezci1,2

  • 1Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, USA.

Translational Vision Science & Technology
|August 22, 2020
PubMed
Summary

Micropulse transscleral cyclophotocoagulation (MP-TCP) showed no significant histologic changes in cadaveric eyes. Continuous wave transscleral cyclophotocoagulation (CW-TCP) caused notable tissue damage, explaining differing adverse effect rates.

Keywords:
CW-TCPMP-TCPcyclophotocoagulationhistology

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Area of Science:

  • Ophthalmology
  • Histology
  • Medical Devices

Background:

  • Transscleral cyclophotocoagulation is used to treat glaucoma.
  • Understanding the histologic effects of different cyclophotocoagulation modalities is crucial for patient safety.
  • Micropulse transscleral cyclophotocoagulation (MP-TCP) is a newer technique with potentially fewer adverse effects than continuous wave (CW-TCP).

Purpose of the Study:

  • To compare the macroscopic and microscopic histologic changes in eyes treated with MP-TCP versus CW-TCP.
  • To elucidate the tissue-level mechanisms underlying the clinical differences between MP-TCP and CW-TCP.

Main Methods:

  • Cadaveric eye globes were divided and treated with either CW-TCP, MP-TCP (single or double treatment), or no treatment (control).
  • Histologic analysis focused on four specific changes: splitting, separation, coagulation, and destruction of ciliary process epithelium.
  • Logistic regression analysis was used to compare the incidence of histologic changes between treatment groups.

Main Results:

  • CW-TCP treatment led to significantly higher rates of separation, coagulation, and destruction of ciliary processes compared to controls.
  • Full-thickness destruction of ciliary process epithelium was exclusively observed in CW-TCP treated specimens.
  • No significant histologic differences were found between MP-TCP treated eyes and control eyes.

Conclusions:

  • MP-TCP does not induce significant histologic alterations in cadaveric eyes.
  • CW-TCP causes substantial histologic damage to the ciliary processes.
  • These findings support the clinical observation of a more favorable safety profile for MP-TCP compared to CW-TCP.