J Korean Ophthalmol Soc.  2020 Sep;61(9):1072-1078. 10.3341/jkos.2020.61.9.1072.

Short-term Efficacy and Safety of Micropulse Transscleral Cyclophotocoagulation in Korean Patients

• Kim J
• Sung MS
• Park SW

• KMID: 2506482
• DOI: http://doi.org/10.3341/jkos.2020.61.9.1072

Abstract

Purpose
To evaluate the short-term efficacy and safety of a standardized micropulse transscleral diode laser cyclophotocoagulation (micropulse TS-CPC) procedure in Korean glaucoma patients.
Methods
In this retrospective study, the medical records of 19 eyes of 19 patients who were diagnosed with glaucoma, underwent micropulse TS-CPC and were followed for at least 3 months were reviewed. Visual acuity (VA), intraocular pressure (IOP), the number of IOP-lowering eye drops, and the success rate, defined as the percentage of eyes achieving an IOP of 6-21 mmHg with or without medication, or an IOP decrease of ≥20% compared to baseline after the procedure, were evaluated at baseline, 1 week, 1 month and 3 months postoperatively.
Results
The mean age was 58.0 years at the time of treatment. Among 19 eyes that were evaluated, two had a previous history of trabeculectomy, two had an Ahmed ^® Glaucoma Valve implantation, one had selective laser trabeculoplasty, and four had vitrectomy. Baseline mean IOP was 26.21 ± 5.22 mmHg, which significantly decreased to 17.72 ± 4.25 mmHg at postoperative 3 months (p < 0.001). The success rate at postoperative 3 months was 84.2%. Five eyes experienced postoperative hypotony, and persistent corneal epithelial defects in three eyes were successfully treated with topical medication. Two of 19 eyes had a decrease in VA of unknown cause, and 9 eyes had mydriasis due to paralysis in iris constriction, which did not resolve until 3 months follow-up.
Conclusions
Micropulse TS-CPC had a relatively good IOP-lowering effect. However, a rather high proportion of patients had complications from a standardized protocol, and this should be considered when performing micropulse TS-CPC in Korean patients.

Keyword

Cyclophotocoagulation; Glaucoma; Laser therapy; Micropulse