Long-term Efficacy and Safety of Micropulse Transscleral Cyclophotocoagulation in the Treatment of Refractory Glaucoma
Sukhumal Thanapaisal¹, Phornrak Sriphon¹, Sasithorn Thawongklang¹, Piyanan Suparattanagool², Niphon Sayawat¹
Affiliation : ¹ KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, ² Clinical Epidemiology Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Objective: To evaluate the long-term efficacy and safety of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in refractory glaucoma.
Materials and Methods: The present study was a prospective non-comparative interventional study. Patients diagnosed with refractory glaucoma were included for MP-TSCPC. The success rate was defined as an intraocular pressure (IOP) of 6 to 21 mmHg or a reduction of IOP by 20%. The percentage of IOP reduction, number of glaucoma medications, visual acuity (VA), additional procedures, and complications were evaluated.
Results: Twenty eyes of 14 patients were included. The mean follow-up time was 28.1±19.5 months and up to 48 months. The mean preoperative
IOP was 22±10.4 mmHg. The success rate of MP-TSCPC was 43.8% at 36 and 48-months follow-ups. The cumulative proportional success was 47.6% at 48 months with a median survival time of 36 months. IOPs showed significant reduction at 1-week follow-up (P <.05) and were reduced 48.7% at 48 months. The overall number of glaucoma medications (p=0.25) and VA (p=0.23) showed no difference compared to baseline. Fifty percent of eyes required an additional procedure to control IOP. Complications included one case of corneal decompensation and three cases (15%) of cataract progression.
Conclusion: MP-TSCPC demonstrated a high success rate in short-term follow-up, then showed a moderate success rate at intermediate and long-term follow-ups in refractory glaucoma. The treatment should be used with caution in cases with a history of multiple ocular surgery to avoid long-term adverse effects.
Received 11 April 2022 | Revised 25 July 2022 | Accepted 17 August 2022
DOI: 10.35755/jmedassocthai.2022.09.13592
Keywords : Glaucoma; Intraocular pressure; Laser coagulation; Laser therapy
