Clinical Efficacy and Safety Outcomes of Micropulse Trans-Scleral Diode Cyclophotocoagulation in Patients with Advanced Glaucoma.

Abstract:

PRECIS:Micropulse trans-scleral cyclophotocoagulation is only moderately effective in lowering intraocular pressure and useful as an adjunct procedure to other glaucoma surgeries. There was a small risk of loss of vision, prolonged hypotony and phthisis bulbi. AIMS:To determine the efficacy and safety of a single micropulse trans-scleral cyclophotocoagulation (MPTCP) treatment for an Asian population with advanced glaucoma. METHODS:This is a retrospective single-center study of 207 eyes (207 patients) with advanced glaucoma which underwent first-time MPTCP between 1 January 2008 and 31 March 2018. Success was defined as IOP of 6-21▒mmHg or ≥20% reduction in intraocular pressure (IOP) without an increase in glaucoma medication from baseline, and without glaucoma re-operation. The IOP, best-corrected visual acuity (BCVA) and number of glaucoma medications were also analyzed. RESULTS:The mean age was 64.9±16.9 (standard deviation) years. The mean follow-up duration was 18.7±16.2 months. The rate of success at post-operative years 1 and 2 follow-up was 44.1% and 32.6%, respectively. The median survival time of MPTCP was 9.0 months and 85 (40.9%) eyes received re-operation. The mean IOP decreased from 31.5±12.0▒mmHg pre-operatively to 22.1±10.3 and 23.8±11.8 at post-operative years 1 and 2, respectively (P<0.0001). The mean number of glaucoma medications was reduced from 3.3±1.0 pre-operatively to 2.6±1.1 and 2.4±1.1 at post-operative years 1 and 2, respectively (P<0.0001). The significant complications included prolonged hypotony (1 eye [0.5%]), phthisis bulbi (7 eyes [3.4%]) and BCVA reduction (29 eyes [13.9%]). CONCLUSION:Single first-time MPTCP for advanced glaucoma eyes was moderately effective in lowering IOP but >50% failed by one year.

journal_name

J Glaucoma

journal_title

Journal of glaucoma

authors

Lim JYE,Cecilia AM,Lim KAD,Sng C,Loon SC,Lun WXK,Chew TKP,Koh TCV

doi

10.1097/IJG.0000000000001729

subject

Has Abstract

pub_date

2020-10-29 00:00:00

eissn

1057-0829

issn

1536-481X

pub_type

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