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MicroPulse® Transscleral Laser Therapy - Fluence May Explain Variability in Clinical Outcomes: A Literature Review
Tomas M Grippo1,2, Facundo G Sanchez1,3, Joan Stauffer4
1Department of Glaucoma, Grippo Glaucoma & Cataract Center, Buenos Aires, Argentina.
Clinical Ophthalmology (Auckland, N.Z.)
|June 17, 2021
Summary
MicroPulse® Transscleral Laser Therapy (MP-TLT) efficacy varies due to inconsistent parameters. Fluence, a new dose metric, may improve outcome prediction and treatment optimization for MP-TLT.
Area of Science:
- Ophthalmology
- Medical Technology
- Laser Therapy
Background:
- MicroPulse® Transscleral Laser Therapy (MP-TLT) has been used since 2010.
- Varied treatment parameters lead to inconsistent clinical outcomes (intraocular pressure reduction, success rate, durability, safety).
- Difficulty in comparing studies and optimizing MP-TLT parameters due to underreported data.
Purpose of the Study:
- To analyze the impact of exposure time and sweep velocity on energy delivery in MP-TLT.
- To introduce fluence as a standardized "dose" metric for MP-TLT.
- To evaluate fluence as a potentially superior indicator of clinical outcomes compared to total energy.
Main Methods:
- Review and analysis of MP-TLT treatment parameters reported in the literature.
- Explanation of the relationship between exposure time, sweeps per hemisphere (sweep velocity), and energy delivery.
- Introduction and conceptualization of fluence as a unified dose metric.
Main Results:
- Exposure time and sweep velocity significantly influence energy delivery to the eye.
- These critical parameters are often underreported, hindering reproducibility and comparison.
- Fluence is proposed as a comprehensive metric combining all relevant treatment parameters.
Conclusions:
- Standardizing MP-TLT parameters is crucial for consistent clinical outcomes.
- Fluence offers a more reliable measure of light dose than total energy for MP-TLT.
- Adoption of fluence could enhance the predictability and comparability of MP-TLT research and practice.
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