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Transscleral cyclophotocoagulation with MicroPulse® laser versus cyclophotocoagulation with continuous diode laser in patients with open-angle glaucoma

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Abstract

Purpose

To present the efficacy and safety of surgical treatment of moderate to advanced stage of open-angle glaucoma using the surgical method of transscleral cyclophotocoagulation with MicroPulse® laser (Iridex, Silicon Valley, California, USA) and to compare these results with those of continuous transscleral cyclophotocoagulation with diode laser.

Methods

In a prospective observational clinical study 22 patients (30 eyes) with moderate and advanced open-angle glaucoma underwent transscleral cyclophotocoagulation. 15 eyes were treated with transscleral cyclophotocoagulation with MicroPulse® laser with 2500 mW (group A) and 15 eyes with continuous diode laser 810 nm and power between 2000 and 2300 mW (group B). The follow-up period of the study was 12 months.

Results

A reduction of the intraocular pressure > 30% was achieved in 53.3% of the group A and in 60% of the group B during the follow-up period of 12 months. A statistically significant decrease of the number of antiglaucoma agents was observed in group A. One eye (6.6%) of group A underwent additional antiglaucoma procedures to achieve target intraocular pressure. The corresponding percentage is 40% in group B. The postoperative inflammatory response was significantly more limited in group A compared to group B.

Conclusions

The transscleral cyclophotocoagulation with MicroPulse® diode laser with 2500 mW achieves a similar decrease of the intraocular pressure as cyclophotocoagulation with continuous diode laser for the first postoperative months, but more satisfactory reduction of the number of eye drops as well as more limited postoperative inflammatory response.

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Availability of data

All data generated or analyzed during this study are included in this published article.

Abbreviations

AC:

Anterior chamber

BCVA:

Best corrected visual acuity

CCLRU:

Cornea and contact lens research unit

cTS-CPC:

Continuous transscleral cyclophotocoagulation

DMEK:

Descemet membrane endothelial keratoplasty

ECD:

Corneal endothelial cell density

GAT:

Goldmann applanation tonometry

IOP:

Intraocular pressure

MIGS:

Micro-invasive glaucoma surgery

mTS-CPC:

MicroPulse® transscleral cyclophotocoagulation

NRS:

Numeric rating scale

OAG:

Open-angle glaucoma

PEX:

Pseudoexfoliation

POAG:

Primary open-angle glaucoma

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Acknowledgements

There is no support, including pharmacological and industry support.

Funding

The authors have no relevant financial or non-financial interests to disclose. No funding was received for conducting this study.

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Authors and Affiliations

  1. Clinic of Ophthalmology, St. Johannes Hospital in Dortmund, Johannesstraße 9-13, 44137, Dortmund, Germany

    Sofia Fili, Iraklis Vastardis, Georgios Perdikakis & Markus Kohlhaas

Authors
  1. Sofia Fili
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  2. Iraklis Vastardis
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  3. Georgios Perdikakis
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  4. Markus Kohlhaas
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Sofia Fili, Iraklis Vastardis, Georgios Perdikakis and Markus Kohlhaas. The first draft of the manuscript was written by Sofia Fili and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sofia Fili.

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Conflicts of interest

The authors declare that there is no conflict of interest. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers' bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethics approval

All procedures performed in this observatory study involving human participants were in accordance with the ethical standards of the institutional research committee of St-Johannes-Hospital in Dortmund, Germany and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Clinical trial registration

This is an observatory study and no clinical trial registration is necessary.

Consent to participate

Informed consent for participation was obtained from all individual participants included in the study.

Consent to publish

Informed consent for publication was obtained from all individual participants included in the study.

Animal research

No research is performed on animals in this study.

Plant reproducibility

No research is performed on animals in this study.

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No image manipulation is performed in this study.

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Fili, S., Vastardis, I., Perdikakis, G. et al. Transscleral cyclophotocoagulation with MicroPulse® laser versus cyclophotocoagulation with continuous diode laser in patients with open-angle glaucoma. Int Ophthalmol 42, 525–539 (2022). https://doi.org/10.1007/s10792-021-02023-5

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  • DOI: https://doi.org/10.1007/s10792-021-02023-5

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