Micropulse transscleral cyclophotocoagulation in glaucoma treatment: 2 years of observations

Abstract Purpose. To evaluate the results of micropulse cyclophotocoagulation in patients with primary open-angle refractory glaucoma (POAG) and neovascular glaucoma over a 2-year follow-up period. Material and methods. Retrospective study of adult patients with glaucoma after 1 or more sessions of micropulse cyclophotocoagulation (mCPC) over 2 years. The wavelength of the laser beam was 810 nm, total exposure 160 s, number of passes along the quadrant – 4, time spent on 1 pass 10 s, power 2500 mW, duty cycle 31.3 %, pulse duration 0.5 ms, period 1.1 ms. Results.The study included 41 patients, 44 eyes with refractory POAG and neovascular glaucoma. The observation period was 2 years. The maximum decrease in IOP was observed 7 days after the procedure – 38.36 %. By 6 months the effect decreased to 22.2 %. During this period, patients most often required correction of management tactics (increased antihypertensive regimen, repeated mCFC, other glaucoma surgery). We identified one case of hypotension that developed 7 days after mCPC. No other complications were recorded. Conclusion. The transscleral mCPC technique showed high safety of the method and effectiveness in reducing IOP; the procedure does not eliminate the use of local antihypertensive therapy, but reduces the medication load for up to 6 months; the least effect is observed in patients with neovascular glaucoma. Keywords: micropulse transscleral cyclophotocoagulation, refractory glaucoma, intraocular pressure