Micropulse vs. continuous wave transscleral cyclophotocoagulation in neovascular glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Research
• Surgical Interventions

Background:

• Neovascular glaucoma (NVG) is a severe form of glaucoma with limited treatment consensus.
• Current therapeutic options for NVG often present challenges in efficacy and safety.

Purpose of the Study:

• To compare the efficacy and safety of micropulse transscleral cyclophotocoagulation (MP-TSCPC) versus continuous wave transscleral cyclophotocoagulation (CW-TSCPC) in managing NVG.
• To evaluate intraocular pressure (IOP) control, visual acuity (VA), medication use, and complications over a 12-month follow-up.

Main Methods:

• A comparative study involving 24 eyes treated with MP-TSCPC and 22 eyes treated with CW-TSCPC for NVG.
• Procedures utilized Iridex Cyclo G6, MP3, or G-Probe devices.
• Key outcome measures included IOP, VA, number of antiglaucoma medications, and postoperative complications.

Main Results:

• CW-TSCPC demonstrated a higher success rate (54.5%) at 12 months compared to MP-TSCPC (33.3%).
• While both methods reduced IOP, CW-TSCPC showed a trend towards better long-term IOP control, though not statistically significant.
• CW-TSCPC was associated with a significantly higher incidence of serious complications, including worsening VA, hypotony, and phthisis bulbi (P=0.045).

Conclusions:

• Both MP-TSCPC and CW-TSCPC can be employed in NVG management.
• CW-TSCPC offers potentially superior long-term IOP reduction but carries a significantly higher risk of adverse events.
• The choice between MP-TSCPC and CW-TSCPC for NVG requires careful consideration of the trade-off between efficacy and safety.