Real-life experience of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in advanced and uncontrolled cases of several glaucoma types: a multicentric retrospective study

Abstract

Purpose: In this retrospective case series multicentric study, we assessed the efficiency and safety of micropulse transscleral cyclophotocoagulation (MP-TSCPC) among several types of advanced uncontrolled glaucoma cases. This study was intended to be a real-life study. Methods: We treated 55 eyes with the Iridex Cyclo G6 device with the MP3 handpiece (IRIDEX Laser Systems) using a standardized protocol. Patients were followed up for a period of one year with an intention-to-treat protocol. Observation points are day 1, week 1, month 1, month 3, month 6, month 9 and year 1 after treatment. The primary outcome is a significant decrease in intra-ocular pressure (IOP) with a threshold of 20% reduction. The secondary outcomes are a reduction in the number of topical molecules needed to control glaucoma progression and the discontinuation of oral acetazolamide. Results: We observed a significant IOP reduction at every observation point with a mean preoperative IOP of 24.19 mmHg (SEM: 0.96) and mean IOP at final follow-up was 19.50 mmHg (SEM: 1.20). At least 50% of patients reached the significant threshold of 20% IOP reduction at every observation point except for month 6 follow-up. No significant reduction was achieved in the number of topical medications necessary to control glaucoma progression. Mean number of topical medications used at final follow-up is 3.00 (SEM: 0.134). Mean number of topical molecules preoperatively was 3.08 (SEM: 0.138). The discontinuation of oral acetazolamide was obtained with a statistically significant difference (p = 0.003). Conclusion: Thanks to the design of this study, we add some proofs about the efficiency and the safety of MP-TSCPC for the treatment of uncontrolled advanced glaucoma cases in a real-life practice.