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Outcomes of MicroPulse® Transscleral Laser Therapy Using the Revised MicroPulse P3® Delivery Device
Maya Ramachandran1, Jackson Voss1, Jessica Ferrell2
1Department of Ophthalmology, University of Kansas, Kansas City, Kansas, United States.
Aims And Background:
To evaluate the safety and efficacy of MicroPulse® transscleral laser therapy (MP-TLT) using the revised MicroPulse P3® (MP3) probe compared to the original probe.
Materials And Methods:
A retrospective study of 122 consecutive eyes of 99 glaucoma patients who received MP-TLT with a minimum of 12 months follow-up. The primary outcome was success at 12 months, defined as final IOP <18 mm Hg and either IOP reduction of >20% or any medication reduction, without any adverse events or secondary surgical interventions (SSIs) within 12 months.
Results:
Ninety-five eyes in 75 patients were treated with the original probe, and 27 eyes of 24 patients were treated with the revised probe. The mean total energy and fluence used were 113.6 joules (J) and 54.3 J/cm2 for the original probe, and 79.9 J and 140.1 J/cm2 for the revised probe. Subjects were mostly white with primary open-angle glaucoma and a mean age of 70.3 years. Significantly more eyes with advanced glaucoma were treated with the revised probe compared to the original probe (p < 0.001). At baseline, mean IOP was 23.0 ± 7.5 on 2.94 ± 1.19 medications for the original probe compared to 22.6 ± 6.9 (p = 0.799) on 3.15 ± 1.32 medications (p = 0.429) for the revised probe. At 12 months, mean IOP was 17.9 ± 5.9 mm Hg (21.4% reduction) on 2.55 ± 1.40 medications (13.0% reduction) for the original probe compared to 14.8 ± 5.7 mm Hg (29.7% reduction, p = 0.063) on 3.07 ± 1.49 medications (2.2% reduction, p = 0.279) for the revised probe. Thirty-one of 95 eyes (32.6%) and 11 of 27 eyes (40.7%) treated with original and revised MP-TLT, respectively, achieved success at 12 months (p = 0.435). The rate of SSIs was 12% and similar between groups (p = 0.833). Significantly more eyes treated with the original probe underwent repeat MP-TLT within 12 months (44.2 vs 22.2%, p = 0.049). No adverse events occurred in either group.
Conclusion And Clinical Significance:
The revised probe for the MP3 device may result in an improved and longer-lasting IOP-lowering effect compared to the original probe, while maintaining an excellent safety profile.
How To Cite This Article:
Ramachandran M, Voss J, Ferrell J, et al. Outcomes of MicroPulse® Transscleral Laser Therapy Using the Revised MicroPulse P3® Delivery Device. J Curr Glaucoma Pract 2024;18(4):147-154.
Insights
The revised MicroPulse P3 probe for MicroPulse transscleral laser therapy (MP-TLT) shows potential for better, longer-lasting intraocular pressure reduction in glaucoma patients compared to the original probe, with a similar safety profile.
Area of Science:
- Ophthalmology
- Glaucoma treatment
- Laser therapy
Background:
- Glaucoma management requires effective intraocular pressure (IOP) reduction.
- MicroPulse® transscleral laser therapy (MP-TLT) is an established treatment modality.
- Evaluating new delivery devices for laser therapy is crucial for improving patient outcomes.
Purpose of the Study:
- To compare the safety and efficacy of the revised MicroPulse P3® (MP3) probe versus the original probe for MP-TLT.
- To assess the long-term IOP-lowering effects and adverse event rates.
Main Methods:
- Retrospective study of 122 eyes from 99 glaucoma patients undergoing MP-TLT.
- Comparison between eyes treated with the original MP3 probe (95 eyes) and the revised MP3 probe (27 eyes).
- Primary outcome: success at 12 months (IOP <18 mm Hg with >20% reduction or medication decrease, no adverse events/secondary surgical interventions).
Main Results:
- The revised probe group showed a trend towards greater IOP reduction (29.7% vs 21.4%) and lower mean IOP at 12 months (14.8 vs 17.9 mm Hg).
- Success rates at 12 months were similar (40.7% revised vs 32.6% original).
- No significant difference in adverse events or secondary surgical interventions; however, fewer repeat MP-TLT procedures were needed with the revised probe.
Conclusions:
- The revised MP3 probe may offer improved and more sustained IOP reduction compared to the original probe.
- MP-TLT with the revised probe maintains an excellent safety profile.
- Further research may validate the enhanced efficacy of the revised probe in glaucoma management.
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