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Updated: Jul 6, 2026
Ultrasound Cyclo Plasty in Eyes with Glaucoma
Published on: January 26, 2018
Comparison of micropulse and continuous-wave transscleral cyclophotocoagulation: a tertiary center experience
Jiaru Liu1, Tasnim Tabassum2, Yulen Shen3
1Department of Ophthalmology, University of Montreal, Montreal, QC.
Objective:
To compare the effectiveness and safety of micropulse (MP-CPC) and continuous-wave cyclophotocoagulation (CW-CPC).
Design:
A retrospective, comparative cohort study.
Patients:
Patients with all types of glaucoma and severity having received MP-CPC or CW-CPC between 2017 and 2021 followed for 2 years.
Methods:
Complete success is defined as intraocular pressure (IOP) of 6-21 mm Hg and IOP reduction from baseline of 30% or higher with no additional glaucoma medications. Qualified success includes those with additional glaucoma medications. Safety outcomes include vision loss, visual field (VF), optical coherence tomography (OCT), CPC retreatment, additional glaucoma surgeries, and adverse events.
Results:
118 eyes and 114 eyes underwent CW-CPC and MP-CPC, respectively. There was a trend toward better survival in CW-CPC throughout the 24 months, notably at 6 and 18 months (p < 0.04). CW-CPC required significantly less glaucoma medication throughout the follow-up than MP-CPC (p = 0.049). Safety outcomes showed no difference in significant vision loss or change in VF and OCT. Ocular inflammation was more common in the CW-CPC group (33.1% vs 18.4%; p = 0.01), but similar rates of hypotony were observed in both groups (12% vs 9.6%; p = 0.73). The MP-CPC group needed additional incisional glaucoma surgeries sooner than the CW-CPC group (6.7 months vs 10.8 months; p = 0.002).
Conclusion:
CW-CPC demonstrated better IOP control with less use of glaucoma drops than MP-CPC. Early retreatment was more common and occurred sooner in the MP-CPC group. Ocular inflammation was more common with CW-CPC, but overall safety parameters were comparable between the 2 groups.
Insights
Continuous-wave cyclophotocoagulation (CW-CPC) showed better intraocular pressure control and reduced medication needs compared to micropulse cyclophotocoagulation (MP-CPC) in glaucoma patients. While CW-CPC had more inflammation, both treatments had similar safety profiles over two years.
Area of Science:
- Ophthalmology
- Glaucoma Management
- Surgical Interventions
Background:
- Glaucoma treatment often involves lowering intraocular pressure (IOP) to prevent vision loss.
- Cyclophotocoagulation (CPC) is a surgical option for various glaucoma types.
- Micropulse (MP-CPC) and continuous-wave (CW-CPC) are two modalities of CPC with differing energy delivery.
Purpose of the Study:
- To compare the efficacy and safety of MP-CPC versus CW-CPC in glaucoma patients.
- To evaluate IOP control, medication requirements, and adverse events between the two CPC methods.
Main Methods:
- Retrospective comparative cohort study.
- Inclusion of glaucoma patients receiving either MP-CPC or CW-CPC between 2017-2021.
- Two-year follow-up assessing intraocular pressure, medication use, visual fields, OCT, and adverse events.
Main Results:
- CW-CPC demonstrated a trend toward better survival and significantly less need for glaucoma medications over 24 months.
- No significant differences were observed in vision loss or changes in visual field (VF) and optical coherence tomography (OCT).
- Ocular inflammation was more frequent with CW-CPC, but hypotony rates were similar; MP-CPC required earlier additional glaucoma surgeries.
Conclusions:
- CW-CPC offers superior IOP control and reduced medication dependency compared to MP-CPC.
- MP-CPC may necessitate earlier retreatment or additional surgeries.
- Despite differences in inflammation and retreatment rates, overall safety profiles of CW-CPC and MP-CPC were comparable.
