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



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.


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.


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.


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.



Anterior chamber


Best corrected visual acuity


Cornea and contact lens research unit


Continuous transscleral cyclophotocoagulation


Descemet membrane endothelial keratoplasty


Corneal endothelial cell density


Goldmann applanation tonometry


Intraocular pressure


Micro-invasive glaucoma surgery


MicroPulse® transscleral cyclophotocoagulation


Numeric rating scale


Open-angle glaucoma




Primary open-angle glaucoma


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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



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.

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Correspondence to Sofia Fili.

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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.

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

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

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  • Intraocular pressure
  • Transscleral cyclophotocoagulation
  • Glaucoma
  • Antiglaucoma eye drops
  • Intracameral inflammation
  • Macular edema