In the treatment of glaucoma, the ability of continuous-wave (CW) transscleral laser photocoagulation (TSCPC) to lower intraocular pressure (IOP) must be weighed against its established risks. Attempting to reap these benefits without the safety concerns has led to the development of micropulse (MP) TSCPC, which differs from CW-TSCPC in that the energy to the ciliary body is delivered in short pulses with an on and off cycle, in theory reducing the risk for inflammation and hypotony.
Although MP-TSCPC has shown clinical promise, most studies looked at patients who had received prior CW-TSCPC. Investigators behind a recently published study[1] retrospectively reviewed a series of 37 consecutive patients who underwent MP-TSCPC as a first-line cyclodestruction procedure for refractory glaucoma.
Treatment was deemed a success if patients required no further addition of glaucoma medication, no need for further surgery, and no decrease in vision.
In addition, they needed to experience IOP lowering as follows: between 6 and 18 mm Hg and reduced by 20% from baseline (criterion A), between 6 and 15 mm Hg and reduced by 25% from baseline (criterion B), or between 6 and 12 mm Hg and reduced by 30% from baseline (criterion C).
The percentage of success was determined at months 3, 6, and 12.
