Outcomes of micropulse transscleral cyclophotocoagulation in primary open-angle glaucoma, pseudoexfoliation glaucoma, and secondary glaucoma

Abstract

Purpose: The aim of this study is to compare the outcomes of micropulse transscleral cyclophotocoagulation between primary open-angle glaucoma, pseudoexfoliation glaucoma, and other types of secondary glaucoma.

Methods: Outcomes of 96 consecutive patients with refractory, end-stage glaucoma treated with micropulse transscleral cyclophotocoagulation were retrospectively reviewed. Follow-up examinations were performed on a regular basis until 12 months postoperatively. Surgical successes were defined as maintaining intraocular pressure ⩽18 mmHg and ⩾20% reduction in intraocular pressure (criteria A), ⩽15 mmHg intraocular pressure and ⩾25% reduction in intraocular pressure (criteria B), and ⩽12 mmHg intraocular pressure and ⩾30% reduction in intraocular pressure from baseline (criteria C).

Results: Ninety-six eyes of 96 patients (50 (52%) females, 46 (48%) males) were included. Among all eyes, 32 were primary open-angle glaucoma, 30 were pseudoexfoliation glaucoma, and 34 were other types of secondary glaucoma. The mean age was 59.37 ± 11.45 (range: 20-91) years. The mean follow-up period was 14.2 ± 3.9 (range: 12-16) months. At 12 months, the success rates of primary open-angle glaucoma, pseudoexfoliation glaucoma, and secondary glaucoma group were 68.75%, 66.6%, and 64.7% (p = 0.185) for criteria A; 56.25%, 53.3%, and 50% (p = 0.153) for criteria B; and 43.75%, 43.3%, and 38.2% (p = 0.146) for criteria C. Four patients (12.5%) in primary open-angle glaucoma group, 5 patients (16.6%) in pseudoexfoliation glaucoma group, and 14 (41.2%) patients in other secondary glaucoma group required reoperation during the follow-up (p < 0.05).

Conclusion: Micropulse transscleral cyclophotocoagulation is an equally effective method of lowering intraocular pressure in patients with primary open-angle glaucoma, pseudoexfoliation glaucoma, and other types of secondary glaucoma. The rate of reoperation was higher in refractory secondary glaucoma patients.

Keywords: Ciliary body ablation procedures; aqueous humor dynamics; biochemistry/physiology of aqueous; glaucoma; laser surgery; open-angle glaucoma.