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Clinical outcomes of micropulse transscleral cyclophotocoagulation in refractory glaucoma—18 months follow-up

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The aim of this study is to evaluate the clinical outcomes of micropulse transscleral cyclophotocoagulation (mTSCPC) in cases of refractory glaucoma. Patients with refractory glaucoma were selected to undergo mTSCPC, using the MP3 handpiece from Iridex Laser Systems. Follow-up examinations occurred on a regular basis for 18 months after the procedure. One hundred eyes of 97 patients were treated. Mean pre-laser intraocular pressure (IOP) was 39.14 ± 13.84 mmHg. This was reduced significantly to 22.77.8 ± 10.48 mmHg (41.82% reduction; p < 0.001) at week 1. At months 1, 3, 6, 12, and 18 the IOP mean was 23.81 ± 9.44, 24.27 ± 9.17, 23.09 ± 8.47, 22.76 ± 8.14, and 22.77 ± 8.13 mmHg. The success rate at 18 months was the highest 90.91% for the group with IOP below 26 mmHg and the lowest 70.00% for the IOP group 26–30 mmHg. The mean number of anti-glaucoma drops decreased from 2.63 ± 0.87 to 1.78 ± 0.95. The number of treatments performed was 1.26. The pain felt during the procedure was reported as being moderate. No major postoperative complications were noted. Micropulse transscleral cyclophotocoagulation is a non-invasive, repeatable laser procedure that offers both good and stable results in lowering IOP and decreases the use of antiglaucoma medications for up to 18 months.

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  1. Kingman S (2004) Glaucoma is second leading cause of blindness globally. Bull World Health Organ 82:887–888

    PubMed  PubMed Central  Google Scholar 

  2. Tham YC, Li X, Wong TY et al (2014) Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 121:2081–2090

    Article  Google Scholar 

  3. Flaxman SR, Bourne RA, Resnikoff S, Ackland P et al (2017) Global causes of blindness and distance vision impairment 1990–2020: a systematic review and meta-analysis. Lancet Glob Health 5(12):1221–1234

    Article  Google Scholar 

  4. Kim C, Demetriades AM, Radcliffe NM (2014) One year of glaucoma research in review: 2012 to 2013. Asia Pac J Ophthalmol (Phila) 3(1):48–55

    Article  Google Scholar 

  5. Leske MC, Heijl A, Hussein M et al (2003) Early Manifest Glaucoma Trial Group. Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. Arch Ophthalmol 121:48–56

    Article  Google Scholar 

  6. Weinreb R, Khaw PT (2004) Primary open-angle glaucoma. Lancet. 363:1711–1720

    Article  Google Scholar 

  7. Mokbel TH (2011) End stage glaucoma. In: Rumelt S (ed) Glaucoma - basic and clinical concepts. IntechOpen, pp 391–400

  8. Tan AM, Chockalingam M, Aquino MC, Lim ZIL, See JLS, Chew PTK (2010) Micropulse transscleral diode laser cyclophotocoagulation in the treatment of refractory glaucoma. Clin Exp Ophthalmol 38:266–272

    Article  Google Scholar 

  9. Toyos MM, Toyos R (2016) Clinical outcomes of micropulsed transcleral cyclophotocoagulation in moderate to severe glaucoma. J Clin Exp Ophthalmol 7(6):1–3

    Google Scholar 

  10. Preda MA, Popa G, Karancsi OL, Musat O, Popescu SI, Munteanu M, Popa Z (2018) Effectiveness of subconjunctival bevacizumab associated with a laser-based procedure in the treatment of neovascular glaucoma. Farmacia 66(4):621–626

    Article  Google Scholar 

  11. Sanchez FG, Peirano-Bonomi JC, Grippo TM (2018) Micropulse transscleral cyclophotocoagulation: a hypothesis for the ideal parameters. Med Hypothesis Discov Innov Ophthalmol 7(3):94–100

    PubMed  PubMed Central  Google Scholar 

  12. R Core Team R (2019) A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. ISBN 3–900051–07-0, URL

  13. Aquino MC, Barton K, Tan AM, Sng C, Li X, Loon SC, Chew PT (2014) Micropulse versus continuous wave transscleral diode cyclophotocoagulation in refractory glaucoma: a randomized exploratory study. Clin Exp Ophthalmol 43(1):40–46

    Article  Google Scholar 

  14. Emanuel ME, Grover DS, Fellman RL et al (2017) Micropulse cyclophotocoagulation: initial results in refractory glaucoma. J Glaucoma 26(8):726–729

    Article  Google Scholar 

  15. Fong AW, Lee GA, O'Rourke P, Thomas R (2011) Management of neovascular glaucoma with transscleral cyclophotocoagulation with diode laser alone versus combination transscleral cyclophotocoagulation with diode laser and intravitreal bevacizumab. Clin Exp Ophthalm 39(4):318–323

    Article  Google Scholar 

  16. Kuchar S, Moster MR, Reamer CB (2016) Treatment outcomes of micropulse transscleral cyclophotocoagulation in advanced glaucoma. Lasers Med Sci 31(2):393–396

    Article  Google Scholar 

  17. Sarrafpour S, Saleh D, Ayoub S, Radcliffe NM (2019) Micropulse transscleral cyclophotocoagulation a look at long-term effectiveness and outcomes. Ophthalmol Glaucoma 2(3):167–171

    Article  Google Scholar 

  18. Lee JH, Shi Y, Amoozgar B, Aderman C, De Alba CA, Lin S, Han Y (2017) Outcomes of MicroPulse laser TSCPC on pediatric vs adult glaucoma patients. J Glaucoma 26(10):936–939

    Article  Google Scholar 

  19. Yelenskiy A, Gillette TB, Arosemena A et al (2018) Patient outcomes following micropulse transscleral cyclophotocoagulation: intermediate-term results. J Glaucoma 27(10):920–925

    Article  Google Scholar 

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The authors would like to thank Marius Ardelean for statistical analyses.

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Correspondence to Mihnea Munteanu.

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The authors have no conflict of interests and received no funding for this work.

The study was conducted in accordance with the Helsinki Declaration and in line with the “International Standard of Good Clinical Practice (ICH-GCP E6 STEP 4).

The study received the local Ethics Committee approval nr. 1/01.06.2016 and was registered on the” Iranian Registry of Clinical Trials”, with the reference number IRCT20170325033136N2.

One of the inclusion criteria for our study was signed informed consent.

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Preda, M.A., Karancsi, O.L., Munteanu, M. et al. Clinical outcomes of micropulse transscleral cyclophotocoagulation in refractory glaucoma—18 months follow-up. Lasers Med Sci 35, 1487–1491 (2020).

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