Micropulse versus continuous wave transscleral diode cyclophotocoagulation in refractory glaucoma: a randomized exploratory study

Aquino, Maria Cecilia; Barton, Keith; Tan, Anna; Sng, Chelvin C. A.; Li, Xiang; Loon, Seng Chee; Chew, Paul

doi:10.1111/ceo.12360

Cited by 255 publications

(361 citation statements)

References 24 publications

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“…Recently, the micropulse diode laser [14] and UCP [8] have been introduced among others as novel techniques to partially destroy the ciliary body, with a more predictable and controlled IOP reduction as compared to traditional cyclodestructive procedures. Recent studies showed that UCP also induces the stimulation of the suprachoroidal and transscleral portions of the uveoscleral outflow pathway, thus allowing another additional hypotensive effect [7,9,15].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Cyclo-Plasty in Patients with Glaucoma: 1-Year Results from a Multicentre Prospective Study

et al. 2018

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Purpose: The aim of this study was to evaluate the safety and efficacy of ultrasound cyclo-plasty (UCP) for reducing intraocular pressure (IOP) in patients with glaucoma. Methods: This is a multicentre prospective study conducted in 3 Italian glaucoma centres. UCP was performed by EyeOP1, which delivers ultrasound beams using 6 piezoelectric transducers activated for 4/6 s (first generation) or 8 s (second generation). Primary outcomes were the mean IOP reduction and the rates of success after 1 year. Secondary outcomes were the mean IOP reduction at each follow-up, and the reduction of the number of hypotensive medications. Results: In total, 49 eyes from 47 patients were treated. One year postoperatively, the mean IOP had decreased from 27.7 ± 9.2 to 19.8 ± 6.9 mm Hg (p < 0.001), and the mean number of hypotensive drops and tablets had decreased from 3.2 and 0.5 to 2.3 and 0.2, respectively (p < 0.05). Postoperative IOP reduction was significantly related to preoperative IOP (r² = 0.5034; p < 0.0001). Second-generation probes determined a significantly higher IOP reduction (p < 0.05). Qualified success was achieved in 25 eyes (51.1%) and complete success in 21 (42.9%), while failure was recorded in 12 (24.5%). Conclusions: UCP is safe and effective for reducing IOP. The procedure determines a greater IOP reduction in patients with higher preoperative IOP. Second-generation probes improve outcomes without detrimental effects on safety.

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Section: Discussionmentioning

confidence: 99%

Ultrasound Cyclo-Plasty in Patients with Glaucoma: 1-Year Results from a Multicentre Prospective Study

et al. 2018

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“…At 18 months, significantly higher proportion of patients who received MP-TSCPC achieved successful outcome when compared to patients who received CW-CPC. There was no significant difference in retreatment rates and the ocular complication rate was significantly higher in eyes treated with CW-TSCPC [60].…”

Section: Micropulse Transscleral Cyclophotocoagulation (Mp-tscpc)mentioning

confidence: 71%

Minimally Invasive Modalities for Treatment of Glaucoma: An Update

Lee¹,

Amoozgar²,

Han³

2017

J Clin Exp Ophthalmol

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Purpose of Review: In recent years, Minimally Invasive Glaucoma Surgery (MIGS) and laser-based procedures have been gaining popularity as glaucoma treatment options. As such, they represent active areas of research. This article reviews some of the notable recent and forthcoming developments in this field. Recent Findings:The MIGS devices and cyclophotocoagulation have been focused on achieving satisfactory success rate as either combined with phacoemulsification or standalone procedure. They also have superior safety profile when compared to traditional incisional glaucoma surgeries. In addition to the promising data available thus far, more comprehensive investigations on the long-term efficacy and safety of these interventions are currently underway.Summary: New minimally invasive surgical modalities have shown considerable potential in intraocular pressure (IOP) and the number of post-surgical medications with rare complications. The rising popularity of these devices and procedures may represent a shift in treatment paradigm from medical therapy towards earlier surgical intervention, especially in the treatment of mild-to-moderate glaucoma.

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“…Aktuelle Fortschritte haben die Behandlungsoptionen bei refraktärem Glaukom um eine neue Methode erweitert: eine transsklerale Diodenlasertherapie für das Auge mit Mikropuls-Diodenlaser und Behandlung durch die Pars plana mit modifizierter Kontaktsonde [56,57]. Es wurde postuliert, dass die thermische Lokalisierung mit einem Mikropuls-Diodenlaser es ermöglicht, kollaterale Gewebeschäden gering zu halten und so die ausgeprägte Gewebezerstörung im Ziliarkörper, Epithel und in den Zilienfortsätzen zu vermeiden, die in histologischen Proben nach konventioneller transskleraler Zyklophotokoagulation (TSCPC) beobachtet worden ist [58].…”

Section: Therapieoptionenunclassified

“…Unter peribulbärer Anästhesie lässt sich der genannte Eingriff mit einer 810-nm-Infrarot-Diodenlaserstrahlung mit 2000 mW [56,57] im Mikropulsmodus (MP-TSCPC; IQ810 Laser Systems, IRIDEX, CA, Mountain View, USA) durchführen. Die Sonde ermöglicht die präzise Positionierung der Lichtleiterspitze 3 mm posterior des Limbus [56] entsprechend der Lokalisation der Pars plana.…”

Section: Therapieoptionenunclassified

“…Die Sonde ermöglicht die präzise Positionierung der Lichtleiterspitze 3 mm posterior des Limbus [56] entsprechend der Lokalisation der Pars plana. Die Laserbestrahlung in den gewählten Einstellungen wird über 100 s (Mikropuls-Rahmen) mit 0,5 ms Ein- und 1,1 ms Auszeit (Leistungszyklus 31,3%) appliziert [56,57]. So wird eine Gesamtenergie von 62,6 J in einer kontinuierlichen, gleitenden, bogenförmigen Vor- und Rückwärtsbewegung («Pinselstriche») zwischen der 09:30- und der 02:30-Uhr-Position im oberen Quadranten für 50 s und zwischen der 03:30- und 08:30-Uhr-Position im unteren Quadranten für weitere 50 s appliziert; die 3- und 9-Uhr-Meridianpositionen bleiben ausgespart und Regionen mit ausgedünnter Sklera werden umgangen [56].…”

Section: Therapieoptionenunclassified

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Chirurgische Behandlung des Engwinkelglaukoms

Lim¹,

Aquino²,

Chew³

2018

Kompass Ophthalmol

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Fortschritte in der Bildgebung des vorderen Segments haben neue Erkenntnisse für ein besseres Verständnis der verschiedenen Mechanismen des Engwinkelglaukoms (EWG) geliefert. Diese Entwicklung ist von großer Bedeutung für eine gute Entscheidungsfindung bei Patienten mit EWG, die eine adäquate Therapie benötigen. Das chirurgische Management des EWG ist nach wie vor ein integraler Bestandteil der Patientenversorgung bei Glaukom. Die spezielle Anatomie des Auges mit Winkelverschluss und das geringe Maß an verfügbarer objektiver Evidenz für die Wirksamkeit der verschiedenen chirurgischen Behandlungsoptionen stellen Glaukomchirurgen vor Herausforderungen. Übersetzung aus Dev Ophthalmol. Basel, Karger, 2017, vol 59, pp 147-154 (DOI: 10.1159/000458493)

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Micropulse versus continuous wave transscleral diode cyclophotocoagulation in refractory glaucoma: a randomized exploratory study

Abstract: Diode transscleral cyclophotocoagulation in both micropulse and continuous modes was effective in lowering intraocular pressure. The micropulse mode provided a more consistent and predictable effect in lowering intraocular pressure with minimal ocular complications.

Cited by 255 publications

References 24 publications

Ultrasound Cyclo-Plasty in Patients with Glaucoma: 1-Year Results from a Multicentre Prospective Study

Ultrasound Cyclo-Plasty in Patients with Glaucoma: 1-Year Results from a Multicentre Prospective Study

Minimally Invasive Modalities for Treatment of Glaucoma: An Update

Chirurgische Behandlung des Engwinkelglaukoms

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