Comparative Outcomes Between Micropulse and Slow-Coagulation Transscleral Cyclophotocoagulation in Eyes With Good...

Despite both CW-TSCPC and MP-TSCPC being effective in reducing IOP, with low rates of complications, MP-TSCPC appears to achieve higher success rates with less significant visual acuity loss compared with CW-TSCPC.

To compare the efficacy and safety of continuous wave transscleral cyclophotocoagulation (CW-TSCPC) using the slow-coagulation technique versus micropulse (MP) TSCPC in patients with glaucoma and good visual acuity.

Retrospective multicenter study including patients with logMAR visual acuity (VA) of <0.5 and at least 6 months of follow-up. Surgical success was defined as IOP ≤18 mm Hg and at least a 30% reduction from baseline IOP with or without glaucoma medication, without loss of >2 lines of vision. For criterion A, patients who required a new CPC session during follow-up were considered a failure. For criterion B, the additional need for CPC was not considered a failure.

We included a total of 200 eyes from 200 glaucoma patients (110 eyes in the CW-TSCPC and 90 in the MP-TSCPC groups). There was a significant reduction in IOP levels and the number of medications after CPC in both groups ( P <0.001). Considering criterion A, success rates at 12 months were 61% and 76% in the CW-TSCPC and MP-TSCPC groups, respectively ( P =0.087). Considering criterion B, success rates were 75% and 87% in the CW-TSCPC and MP-TSCPC groups, respectively ( P =0.289). Significant VA loss was observed in 20% of the eyes in the CW-TSCPC group and 10% of the eyes in the MP-TSCPC group ( P =0.016).

Both CW-TSCPC and MP-TSCPC are safe and effective in reducing IOP, with low rates of complications or serious adverse events.