Long-Term Postoperative Outcomes of Micropulse Transscleral Cyclophotocoagulation (MP-TSCPC) in Patients with...

To report long-term postoperative outcomes of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in patients with glaucoma.

This study investigated 50 eyes in 45 patients (mean age: 67.5 ± 13.4 years) who underwent MP-TSCPC and had at least 24 months of postoperative follow-up. Causative diseases were primary open-angle glaucoma (38 eyes), pseudoexfoliation glaucoma (5 eyes), neovascular glaucoma (3 eyes), secondary glaucoma (3 eyes), and ocular hypertension (1 eye). Pre- and postoperative intraocular pressure (IOP), topical and/or oral medication scores, and complications were investigated retrospectively.

During the 24-month follow-up, 34 eyes (68%) underwent additional glaucoma intervention because of insufficient IOP control. Kaplan-Meier analysis showed probabilities of remaining free from additional intervention of 58.0% (95% confidence interval [CI], 43.2-70.2%) at 6 months, 48.0% (95% CI, 33.7-60.9%) at 12 months, and 32.0% (95% CI, 19.7-45.0%) at 24 months; the median additional-intervention-free time was 10 months. In the 16 eyes that remained free from additional intervention for 24 months, IOP decreased significantly at 1, 2, and 3 months compared with baseline after Holm correction (P < 0.05 each), but not at 6 months or later. Medication scores did not decrease. Previous glaucoma surgery was more frequent in eyes requiring additional intervention (41.2% vs 12.5%, P = 0.043). Mild or transient mydriasis occurred in 41 eyes (82%) and had resolved in 92% of affected eyes by 6 months.

Most eyes required additional glaucoma intervention within 24 months after MP-TSCPC, and the probability of remaining free from additional intervention was 32.0% at 24 months. Among eyes not requiring additional intervention, the early IOP-lowering effect was not sustained beyond 3 months. MP-TSCPC remains a relatively nonincisional treatment option with few serious complications, but patients should be counseled regarding the frequent need for subsequent glaucoma intervention.