[Micropulsed diode laser transscleral cyclophotocoagulation: An effective technique whose role remains to be defined]

Area of Science:

• Ophthalmology
• Glaucoma Treatment
• Surgical Procedures

Background:

• Micropulse Transscleral Cyclophotocoagulation (MP-TSCP) is a newer, less aggressive alternative to conventional Transscleral Cyclophotocoagulation (TSCP).
• Evaluating MP-TSCP in real-world clinical settings is crucial for understanding its practical application.

Purpose of the Study:

• To assess the safety and efficacy of MP-TSCP for managing severe and/or refractory glaucoma.
• To determine the long-term outcomes and retreatment rates associated with MP-TSCP.

Main Methods:

• Retrospective analysis of MP-TSCP cases performed between January 2017 and September 2019.
• Recorded preoperative and postoperative intraocular pressure (IOP), medication use, and adverse events.
• Success defined as IOP between 6-21mmHg with medication reduction or >20% IOP decrease.

Main Results:

• Thirty eyes (28 patients) with severe glaucoma were included; 43% had prior filtering surgery.
• Mean follow-up was 13.5 months; 37% of patients required retreatment.
• Achieved IOP reduction of 33% at 3 months (P<0.0001), with success rates around 50-57% throughout follow-up.
• Severe adverse events included corneal ulcers and transient ocular hypotony.

Conclusions:

• MP-TSCP demonstrates effectiveness in treating severe or refractory glaucoma.
• Retreatment is necessary in over one-third of cases, highlighting the need for further research.
• Identifying predictors of success and optimal retreatment strategies is essential for future clinical practice.