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Slow-Coagulation Continuous-Wave Cyclophotocoagulation vs. Micropulse Laser Treatment Procedure in Refractory
Luiz A F Beniz1, Mariana C Ikeda1, Eloisa G R M Teixeira2
1Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil.
Ophthalmology. Glaucoma
|October 18, 2025
Summary
Slow-coagulation continuous-wave cyclophotocoagulation (SC-CPC) significantly outperformed micropulse laser treatment (MP-LT) in managing refractory glaucoma, achieving better intraocular pressure control and lower failure rates over 18 months.
Area of Science:
- Ophthalmology
- Glaucoma Management
- Laser Therapy
Background:
- Refractory glaucoma presents a significant challenge in intraocular pressure (IOP) management.
- Transscleral diode laser cyclophotocoagulation is a treatment option for advanced glaucoma.
- Comparing different laser modalities is crucial for optimizing treatment outcomes.
Purpose of the Study:
- To compare the efficacy of slow-coagulation continuous-wave cyclophotocoagulation (SC-CPC) versus micropulse laser treatment (MP-LT).
- To evaluate outcomes in patients with refractory glaucoma undergoing transscleral diode laser cyclophotocoagulation.
- To assess treatment success, IOP reduction, and complication rates over 18 months.
Main Methods:
- A prospective, 2-center randomized clinical trial involving 60 eyes of 60 patients with medically uncontrolled glaucoma.
- Patients were randomized to either SC-CPC or MP-LT with standardized laser parameters.
- Success was defined by postoperative IOP between 6-18 mmHg, ≥20% reduction, and absence of further interventions or significant vision loss.
Main Results:
- SC-CPC achieved a significantly higher treatment success rate (70.0%) compared to MP-LT (30.0%) (P = 0.001).
- The SC-CPC group exhibited lower mean IOP (18.4 mmHg vs. 22.5 mmHg, P = 0.005) and a greater IOP reduction (23.1% vs. 11.5%, P = 0.020).
- Fewer IOP-lowering medications were required in the SC-CPC group, and retreatments/surgeries were more frequent with MP-LT.
Conclusions:
- Slow-coagulation continuous-wave cyclophotocoagulation (SC-CPC) demonstrates superior efficacy in controlling IOP for refractory glaucoma.
- SC-CPC offers a lower surgical failure rate compared to micropulse laser treatment (MP-LT).
- These findings support SC-CPC as a more effective therapeutic option for refractory glaucoma patients.
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