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Evidence-Based Consensus Guidelines Series for MicroPulse Transscleral Laser Therapy: Dosimetry and Patient

Tomas M Grippo1, Ronald M P C de Crom2, Michael Giovingo3

  • 1Department of Ophthalmology, Hospital Aleman, Buenos Aires, Argentina.

Clinical Ophthalmology (Auckland, N.Z.)
|June 14, 2022
PubMed
Summary

Consensus guidelines for MicroPulse Transscleral Laser Therapy (TLT) in glaucoma treatment are established. Recommended settings include 2500 mW, 31.3% duty cycle, and 4 sweeps per hemisphere for optimal patient selection and dosimetry.

Keywords:
MicroPulseglaucomatransscleral laser therapy

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Area of Science:

  • Ophthalmology
  • Medical Devices
  • Laser Therapy

Background:

  • Glaucoma management requires effective and safe treatment options.
  • MicroPulse Transscleral Laser Therapy (TLT) has emerged as a valuable modality.
  • Optimal parameters for MicroPulse TLT were not consistently defined.

Purpose of the Study:

  • To establish consensus-based guidelines for MicroPulse TLT.
  • To define optimal dosimetry and patient selection criteria.
  • To synthesize current literature and expert opinion.

Main Methods:

  • A comprehensive literature review of 61 studies on MicroPulse TLT.
  • A three-round Delphi method to achieve expert consensus.
  • A live meeting with 80% expert attendance for final agreement.

Main Results:

  • Consensus was reached on laser settings and patient selection for MicroPulse TLT.
  • Recommended standard settings: 2500 mW, 31.3% duty cycle, 4 sweeps (20s each/hemisphere).
  • Treatment should avoid 3 and 9 o'clock positions in both hemispheres.

Conclusions:

  • MicroPulse TLT is a safe and effective addition to glaucoma treatment.
  • Adherence to recommended settings ensures efficacy and safety.
  • Guidelines provide crucial direction for MicroPulse TLT application.