Micropulse Transscleral Diode Laser Cyclophotocoagulation in Refractory Glaucoma: Short-Term Efficacy, Safety, And Impact of Surgical History on Outcomes

Abstract Purpose To assess the short-term efficacy and safety of micropulse transscleral diode laser cyclophotocoagulation (MP-TSCPC) in the management of refractory glaucoma, and to compare outcomes based on prior glaucoma surgeries. Design Retrospective analysis. Subjects /Participants/Controls: Patients with refractory glaucoma who underwent MP-TSCPC at a single institution by four surgeons. Methods Chart review of cases of MP-TSCPC using the Iridex Cyclo G6 laser with standard parameters, and laser duration at the discretion of each treating physician. Main Outcome Measures Probability of postoperative success was estimated by the Kaplan-Meier method. Success parameters included: intraocular pressure (IOP) 6-21 mmHg with or without topical anti-hypertensive therapy, > 20% IOP reduction from baseline for any two consecutive visits after three postoperative months, and no subsequent glaucoma surgery. Results 116 eyes of 116 subjects (mean age = 65.8 ± 16.9 years) were included. Baseline IOP was 22.2 ± 7.9 mmHg, and mean postoperative follow-up time was 6.3 ± 3.4 months (range 3-12 months.) Postoperative IOP at the final follow up was 15.3 ± 6.6 mmHg (P Conclusions MP-TSCPC has a significant short-term ocular hypotensive effect and favorable safety profile in eyes with refractory glaucoma. The probability of successful outcome was greater in eyes with prior traditional glaucoma surgery. Precis In eyes with refractory glaucoma, micropulse transscleral cyclophotocoagulation yielded significant short-term intraocular pressure lowering and minimal short term complications. Higher likelihood of successful outcome was observed in eyes with prior traditional glaucoma surgery.