Novel Micropulse Transscleral Cyclophotocoagulation System for Clinical Treatment of Refractory Glaucoma

Traditional transscleral cyclophotocoagulation has been established as an effective intervention for refractory glaucoma. While demonstrating therapeutic efficacy, conventional TSCPC raises concerns regarding potential complications to ocular structures. In contrast, micropulse transscleral cyclophotocoagulation (MP-TSCPC) represents a significant advancement by selectively targeting pigmented epithelium to modulate aqueous humor production. This innovative approach has emerged as a well-tolerated treatment modality with reduced complication risks, supported by an increasing body of clinical evidence. This protocol details the application of a commercially available MP-TSCPC system for intraocular pressure reduction and complication mitigation in refractory glaucoma management. The procedure requires specific instrumentation, including the laser system equipped with the Micropulse Pars Plana Procedure (MP3) handpiece. Treatment efficacy and safety are governed by four critical parameters: power, duty cycle, treatment duration, and dwell time, which collectively determine the total energy delivered to the ciliary body. This paper systematically reviews the methodological framework for implementing MP-TSCPC in refractory glaucoma treatment.