Micropulse Transscleral Cyclophotocoagulation

Abdelmassih, Youssef; Tomey, Karim F.; Khoueir, Ziad

doi:10.5005/jp-journals-10078-1298

Cited by 14 publications

(16 citation statements)

References 44 publications

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“…In our study, no significant change was noted in central macular thickness at 3, 6, or 12 months follow-up, except in one case that developed CME, which completely resolved after 8 weeks of nonsteroidal anti-inflammatory drugs. Similar complication has been noted in various other published studies 42,43 …”

Section: Discussionsupporting

confidence: 90%

“…Similar complication has been noted in various other published studies. 42,43 Persistent inflammation ( > 1 mo) associated with decrease in visual acuity has been reported in studies done by Emmanuel et al 36,38 Mild, self-limiting uveitis was reported in 7.5% of eyes by Lee et al 44 However, in our study, we found that the inflammation resolved within 1 month of follow-up period when patients were kept on tapering dose of topical steroids.…”

Section: Discussionsupporting

confidence: 37%

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Efficacy of Micropulse Laser Cyclophotocoagulation Therapy in Primary Angle Closure Glaucoma

Chauhan,

Midha,

Mahalingam

et al. 2023

Journal of Glaucoma

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Précis: In primary angle closure glaucoma (PACG), micropulse cyclophotocoagulation resulted in a significant reduction in intraocular pressure (IOP), and the number of antiglaucoma medications without any sight-threatening complications. However, the IOP lowering efficacy decreased over time. Purpose: The purpose of this study was to evaluate the efficacy and safety of micropulse trans-scleral cyclophotocoagulation (MP-TSCPC) in PACG. Patients and Methods: Thirty-three phakic PACG eyes with patent laser peripheral iridotomy and IOP uncontrolled on maximum tolerable antiglaucoma medications (AGMs), scheduled for trabeculectomy, were given a trial of MP-TSCPC (810 nm laser, 2000 mw power for 180 seconds, 360 degrees). The primary outcome measure was a success at 1 year with IOP ≤18 mm Hg and ≤15 mm Hg with (qualified success) or without (absolute success) AGMs after a single session of MP laser. Secondary outcome measures were changes in pupillary diameter, visual acuity, central macular thickness, and subjective pain perception. Results: Thirty-two out of 33 PACG patients completed 12 months of follow-up. The mean age of patients was 54.7±8.9 years; male:female ratio was 1:1. The baseline IOP was 25.7±5.3 mm Hg, which reduced to 17.9±4.6 mm Hg at the end of 12 months (P<0.0001). Twenty eyes (62.5%) achieved qualified success, and 1 eye (3.125%) had absolute success at 12 months for IOP ≤18 mm Hg; 6 eyes (18.75%) had qualified success, and 1 eye (3.125%) had absolute success for IOP ≤15 mm Hg at 12 months follow-up. A significant reduction was also observed in the number of AGMs (4.4±0.8 at baseline to 2.9±1.1 at 12 months; P <0.0001). Five eyes (15.6%) received additional treatment—3 eyes (9.4%) requiring a subsequent filtering procedure, and 2 eyes (6.2%) requiring an additional MP-TSCPC session. No significant change in pupillary diameter (P=0.489) or central macular thickness (P=0.938) was noted at 12 months. There was a transient drop of visual acuity >2 lines in 1 patient due to cystoid macular edema, and no major postlaser complications were noted. Conclusions: MP-TSCPC can be used as an interim procedure to reduce IOP in PACG eyes and delay the need for invasive surgery. Most patients require continued use of glaucoma medications, and target IOPs achieved are in the high teens.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 37%

Efficacy of Micropulse Laser Cyclophotocoagulation Therapy in Primary Angle Closure Glaucoma

Chauhan,

Midha,

Mahalingam

et al. 2023

Journal of Glaucoma

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“…In eyes with MK, the mean energy used was 52 joules. 10 The 3 and 9 o'clock positions were avoided for most treatments (n 5 58%). The median interval between the first CPC and onset of MK was 4 years (IQR, 2.7-7.4).…”

Section: Resultsmentioning

confidence: 98%

“…The surgical technique for CPC has been previously described. 9,10 The steps and procedures for surgery and postoperative care include using G-Probe (IRIS Medical Instruments Inc, Mountain View, CA) to operate on children under general anesthesia in an operating room under aseptic conditions with transillumination to precisely identify the location of the ciliary body. 11 The surgeon avoided 3 and 9 o'clock positions along the horizontal meridian whenever possible, as well as previous tube implants and scleral thinning sites.…”

Section: Methodsmentioning

confidence: 99%

Incidence and outcomes of microbial keratitis after cyclophotocoagulation to treat childhood refractory glaucoma

Sesma

Ahmad

AlBakri

et al. 2022

Journal of American Association for Pediatric Ophthalmology and

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“…On the other hand, mTLT has been gradually developed into a new alternative laser modality, with the superiority of relatively fewer complications and a decent efficacy [ 2 ]. Most importantly, mTLT expands the indications of cyclophotocoagulation, and it is not only applicable in the advanced stage of glaucoma [ 3 ]. However, the efficacy and safety of mTLT varies across studies, and no relevant systematic review has been conducted.…”

Section: Introductionmentioning

confidence: 99%

The efficacy and safety of micropulse transscleral laser treatment in glaucoma: a systematic review and meta-analysis

et al. 2023

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Objective Micropulse transscleral laser treatment (mTLT) is the latest alternative intraocular pressure (IOP) lowering approach for glaucoma patients. This meta-analysis aims to evaluate the efficacy and safety of mTLT and continuous wave transscleral cyclophotocoagulation (CW-TSCPC) for the treatment of glaucoma. Methods We searched the PubMed, Embase, and Cochrane Library of Systematic Reviews databases from January 2000 to July 2022 to identify studies that, evaluated the efficacy and safety of mTLT in glaucoma. There were no restrictions regarding study type, patient age, or type of glaucoma. We analysed the reduction in IOP and the number of anti-glaucoma medications (NOAM), retreatment rates, and complications between mTLT and CW-TSCPC treatment. Publication bias was conducted for evaluating bias. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA 2020) reporting guideline. Results We identified 6 eligible studies of which only 2 RCTs and 386 participants with various types of glaucoma at different stages were ultimately included. The results revealed significant IOP decreases after mTLT up to 12 months and significant NOAM reductions at 1 month (WMD=-0.30, 95% CI -0.54 to 0.06), and 3 months (WMD=-0.39, 95% CI -0.64 to 0.14) in mTLT compared to CW-TSCPC. Moreover, the retreatment rates (Log OR=-1.00, 95% CI -1.71 to -0.28), hypotony (Log OR=-1.21, 95% CI -2.26 to -0.16), prolonged inflammation or uveitis (Log OR=-1.63, 95% CI -2.85 to -0.41), and worsening of visual acuity (Log OR=-1.13, 95% CI -2.19 to 0.06) occurred less frequently after mTLT. Conclusion Our results demonstrated that mTLT could lower the IOP until 12 months after treatment. mTLT seems to have a lower risk of retreatment after the first procedure, and mTLT is superior to CW-TSCPC with respect to safety. Studies with longer follow-up durations and larger sample sizes are necessary in the future. Trial registration number INPLASY202290120.

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Micropulse Transscleral Cyclophotocoagulation

Abstract: A bstract How to cite this article: Abdelmassih Y, Tomey K, Khoueir Z. Micropulse Transscleral Cyclophotocoagulation. J Curr Glaucoma Pract 2021;15(1):1–7.

Cited by 14 publications

References 44 publications

Efficacy of Micropulse Laser Cyclophotocoagulation Therapy in Primary Angle Closure Glaucoma

Efficacy of Micropulse Laser Cyclophotocoagulation Therapy in Primary Angle Closure Glaucoma

Incidence and outcomes of microbial keratitis after cyclophotocoagulation to treat childhood refractory glaucoma

The efficacy and safety of micropulse transscleral laser treatment in glaucoma: a systematic review and meta-analysis

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