Micropulse Transscleral Cyclophotocoagulation in the Management of Glaucoma Patients

Abstract

This is a prospective, interventional, non-comparative case series was conducted in the department of Ophthalmology, Ain Shams University Hospital on 61 eyes of 46 patients with various glaucoma types and of severity, ranging from mild to severe. In addition to best-corrected visual acuity (BCVA), intraocular pressure (IOP) and the number of glaucoma medications were recorded before and after treatment, along with the post-operative need for systemic carbonic anhydrase inhibitors (CAI), success rates, number of treatment sessions and post-operative complications. Success was defined as an IOP of 6-18 mmHg or at least a 30% decrease from preoperative IOP in the absence of any vision-threatening complications during the 6-month follow-up period. MicroPulse-TSCPC was performed on 61 glaucomatous eyes. Eleven of the 61 eyes (18%) that did not achieve IOP between 6-18 mmHg, or at least a 30% decrease from baseline at 6 months, had a repeat MicroPulse TSCPC session. At 6 months follow-up post a single MicroPulse TSCPC session, the mean IOP reduction was 35.9 ± 14.2%; and 6 months after the second session, it was 36.2 ± 17.5% (p<0.001). The success rate after the first session was 73.8% which increased to 78.7% after the second session. The mean anterior chamber (AC) cell reaction was +1.9 ± 0.8 at 1 day, +1.0 ± 0.7 at 1 week, and +0.2 ± 0.4 at 1 month post-operatively. No cells were detected in any of the cases at 3 and 6 months follow-up (p<0.001). The average number of anti-glaucoma eye drops before MicroPulse TSCPC was 2.6 ± 1.0.