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Micropulse transscleral cyclophotocoagulation in a Taiwanese population: 2-year clinical outcomes and prognostic factors

Abstract

Purpose

To evaluate the 2-year efficacy and safety of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in Taiwanese patients with glaucoma.

Methods

We included the patients who received standardized MP-TSCPC with follow-up examinations on a regular basis for 24 months. Treatment success was defined as the attainment of a postoperative intraocular pressure (IOP) between 6 and 21 mmHg or a ≥ 20% reduction in IOP from baseline without an increase in glaucoma medications.

Results

A total of 60 eyes from 56 patients who underwent MP-TSCPC for refractory glaucoma were included. The median age at MP-TSCPC intervention was 58.9 ± 12.4 years. The percentage of treatment success was 88.3% at 3 months, 83.3% at 6 months, 78.3% at 12 months, and 75.0% at 24 months. The mean baseline IOP prior to MP-TSCPC was 34 ± 11.9 mmHg (range 14–56 mmHg). The mean postoperative IOP decreased to 20.9 ± 10.0 mmHg, 18.0 ± 7.8 mmHg, 17.5 ± 6.4 mmHg, and 18.2 ± 7.1 mmHg after 3 months, 6 months, 12 months, and 24 months, respectively, in successful cases. The mean number of glaucoma medications at baseline was 3.8 ± 0.2, and the mean numbers of glaucoma medications at postoperative months 3, 6, 12, and 24 were 2.6 ± 0.7, 2.8 ± 0.6, 2.5 ± 1.4 and 2.6 ± 1.4, respectively, in successful cases. Younger age and prior CW-TSCPC significantly contributed to surgical failure in the multivariate model. Complications after MP-TSCPC included mild anterior chamber inflammation, conjunctival hemorrhage, hypotony, and mydriasis, and all subsided after treatment. None of the eyes developed vitreous hemorrhage, cystoid macular edema, or phthisis bulbi in the late postoperative period.

Conclusions

This study demonstrated that younger age and prior CW-TSCPC were risk factors for MP-TSCPC failure within 2 years. MP-TSCPC might be safe and effective for refractory glaucoma patients with maximal antiglaucoma medications.

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Fig. 1

Data availability

The data of this study are available from the corresponding author upon reasonable request.

Code availability

Not applicable.

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Funding

This study was supported by Chang Gung Memorial Hospital Research Grants (CMRPG3I0071-3 and MRPG3L0151), a Ministry of Science and Technology Research Grant (MOST 109–2314-B-182A-019-MY3) The sponsors had no role in the design or conduct of this research.

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Authors

Contributions

Po-Han Yeh and Chun-Ting Yeh collected the data.

Henry Shen-Lih Chen, Wei-Wen Su, Yung-Sung Lee, Lan-Hsin Chuang, Su-Chin Shen, and Wei-Chi Wu contributed data or analysis tools.

Henry Shen-Lih Chen, Po-Han Yeh, and Chun-Ting Yeh performed the analysis and wrote the paper.

Corresponding author

Correspondence to Po-Han Yeh.

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Ethics approval

We obtained approval from the Institutional Review Board of Chang Gung Medical Foundation (202100095B0), and all the methods described were compliant with the tenets of the Declaration of Helsinki.

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Not applicable.

Conflict of interest

The authors declare no conflict of interest.

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Chen, H.SL., Yeh, PH., Yeh, CT. et al. Micropulse transscleral cyclophotocoagulation in a Taiwanese population: 2-year clinical outcomes and prognostic factors. Graefes Arch Clin Exp Ophthalmol (2021). https://doi.org/10.1007/s00417-021-05468-7

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Keywords

  • Intraocular pressure
  • Glaucoma
  • Treatment lasers
  • Micropulse