Efficacy and Safety of Micropulse® Transscleral Cyclophotocoagulation in Glaucoma

Objective: To report the results using Micropulse^® transscleral cyclophotocoagulation (Iridex) in the treatment of glaucoma.

Methods: Retrospective study in adult patients with glaucoma with at least 6 months of follow-up, and only one session of Micropulse^®. The same surgical technique was used in all cases. The only laser parameter that could vary was the total treatment duration (in seconds). The remaining parameters were fixed at 2 Watts of power and 0.5ms (31.3%) of active cycle.

Results: A total of 22 eyes of 17 patients with glaucoma of various types and stages were included (mainly congenital and pseudoexfoliation). The mean follow-up time was 7.9 months. The total treatment duration varied from 100 to 180seconds. Definition of success: 5mmHg <Intraocular pressure (IOP)<21mmHg and a reduction of ≥20% of the baseline value and no addition of oral carbonic anhydrase inhibitors, and no re-operation. The overall success rate was 72.7% in the first month, 54% at 4 months, 41% at 6 months, and 27.3% at final follow-up. Patients with longer treatment durations (180s) achieved better results. The mean reduction in IOP in successful eyes was 36% (from 26.3 to 16.7mmHg, SD 4.58, P=.028). No complications were reported.

Conclusions: In a heterogeneous population of glaucoma (mostly congenital and pseudoexfoliation types), a low success rate (27.3%) was obtained in the medium-term with a single session of Micropulse^®.