Efficacy of slow-coagulation cyclophotocoagulation after failed MicroPulse cyclophotocoagulation in refractory...

Area of Science:

• Ophthalmology
• Glaucoma Treatment
• Surgical Interventions

Background:

• Refractory glaucoma poses a challenge, often requiring multiple interventions.
• MicroPulse transscleral cyclophotocoagulation (MP-TSCPC) is a treatment option, but its failure necessitates alternative strategies.
• The efficacy of slow-coagulation continuous wave cyclophotocoagulation (SC-CWCPC) after MP-TSCPC failure is not well-established.

Purpose of the Study:

• To evaluate the efficacy and safety of SC-CWCPC in patients with uncontrolled intraocular pressure (IOP) following a failed MP-TSCPC procedure.
• To determine the success rate of SC-CWCPC in managing refractory glaucoma.
• To assess the impact of SC-CWCPC on IOP and medication requirements post-MP-TSCPC failure.

Main Methods:

• Retrospective case series of patients who underwent SC-CWCPC after MP-TSCPC failure.
• Procedures performed by a single glaucoma surgeon between January 2022 and October 2024.
• Surgical success defined by IOP between 6-21 mmHg, ≥20% IOP reduction, no reoperation, and preserved light perception vision.

Main Results:

• Eight patients (10 eyes) with a mean age of 43.75 years were included.
• Preoperative IOP of 26.10 mmHg on 3.1 medications reduced to 15.80 mmHg post-SC-CWCPC (p=0.002).
• An 80% success rate was achieved, with a mean follow-up of 10.97 months; no significant vision loss or hypotony occurred.

Conclusions:

• SC-CWCPC is an effective and safe treatment for refractory glaucoma patients who have failed MP-TSCPC.
• This technique expands the surgical options for managing complex glaucoma cases.
• SC-CWCPC offers a viable solution for IOP control when other methods have not succeeded.