Slow-Coagulation Transscleral Cyclophotocoagulation in Pseudoexfoliation Glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Medical Devices

Background:

• Pseudoexfoliation glaucoma (PXG) presents unique challenges for intraocular pressure (IOP) management.
• Medically uncontrolled PXG often requires advanced surgical interventions.
• Transscleral cyclophotocoagulation (TSCPC) is an established glaucoma treatment modality.

Purpose of the Study:

• To evaluate the efficacy and safety of slow-coagulation transscleral cyclophotocoagulation (SC-TSCPC) in patients with pseudoexfoliation glaucoma (PXG).
• To assess the surgical success rates and IOP reduction following SC-TSCPC.
• To document the need for retreatment and associated complications.

Main Methods:

• Retrospective, single-center study of 48 eyes with medically uncontrolled PXG undergoing SC-TSCPC.
• Standardized laser parameters: 1250-milliwatt power and 4-second duration.
• Primary outcome: surgical success (IOP 6-21 mmHg, ≥20% reduction, no further surgery/complications); secondary outcomes: IOP, medication use, visual acuity, complications at 1-2 years.

Main Results:

• Qualified success rates at 1 and 2 years were 58.3% and 47.9% (single treatment), increasing to 64.6% and 56.2% with retreatment.
• Complete success rates were 45.8% and 33.3% (single treatment), rising to 50.0% and 39.6% with retreatment.
• Mean IOP decreased significantly from 29.2±10.3 mmHg to 14.3±6.43 mmHg (P<0.001), with reduced medication use.

Conclusions:

• SC-TSCPC demonstrates effectiveness and relative safety as a repeatable surgical option for pseudoexfoliation glaucoma.
• The procedure achieves significant IOP reduction and can be repeated if necessary.
• Further prospective studies are recommended to validate these findings.