Results of micropulse cyclophotocoagulation in patients with early stages of primary open-angle glaucoma.
Abstract
Objective: to evaluate the possibilities of transscleral micropulse cyclophotocoagulation (MP-TSCPC) in patients with early stages of glaucoma.
Material and methods. 38 patients with early stages of primary open-angle glaucoma underwent MP-TSCPC as the primary procedure. For the operation, modified laser parameters were used on the SUPRA 810 device (Quantel Medical, France). The follow-up period averaged 17±11 months (from 6 to 30 months). The Kaplan-Meier scale was used to assess the cumulative success of laser treatment after surgery.
Results. The postoperative period was uneventful. A month after the MP-TSCPC, was noted hypotensive effect averaged 41.5% . After 6 month hypotensive effect continued to persist and averaged 36,1%. By 12 months follow-up, a stable hypotensive effect remained, IOP averaged 16.0±3.5 mm Hg, averaged 31%. No changes in BCVA were detected during the observation period. IOP reduction was achieved in all cases. The parameters of the state of the ONH (OСT, perimetry) remained stable, or their improvement.
Conclusion. MP- TSCPC in patients with early stages of glaucoma leads to a pronounced stable hypotensive effect during the follow up period, averaged 31% (up20% to50%). An improvement in the quality of life was noted due to the refusal or reduction in the number of instillations. To develop practical recommendations on the indications and regimens of MP-TSCPC in the early stages of glaucoma, further monitoring of patients is carried out.
Key words: open angle glaucoma, early-stage glaucoma; intraocular pressure; micropulse cyclophotocoagulation.
About the Authors
Igor IoshinRussian Federation
Med.Sc.D., Professor, Head of the Center of Ophthalmology
Anna Tolchinskaya
Russian Federation
Med.Sc.D., Ophthalmologist
Anna Rakova
Russian Federation
Ph.D., Ophthalmologist
Ivan Maksimov
Russian Federation
Ophthalmologist.
References
1. Alekseev V.N., Egorov E.A., Malevannaya O.A. Analysis of the main causes of the progression of primary open-angle glaucoma. RMJ. Clinical ophthalmology. 2014; 4:218-223.
2. Glaucoma. National guidance. Ed. E.A. Egorova. Moscow: GEOTAR-Media; 2013. 824 p.
3. Boland MV, Chang DS, Frazier T, Plyler R, Friedman DS. Electronic monitoring to assess adherence with once-daily glaucoma medications and risk factors for nonadherence: the automated dosing reminder study. JAMA Ophthalmol. 2014;132(7):838-844. doi:10.1001/jamaophthalmol.2014.856
4. Dietlein T.S., Rosentreter A., Lappas A. Complexities of medical glaucoma therapy — the elderly patient in focus. Klin Monbl Augenheilkd.2016; 233(2):138–142. doi:10.1055/s-0041-110447
5. Friedman DS, Quigley HA, Gelb L, et al. Using pharmacy claims data to study adherence to glaucoma medications: methodology and findings of the Glaucoma Adherence and Persistency Study (GAPS). Invest Ophthalmol Vis Sci. 2007;48(11):5052-5057. doi:10.1167/iovs.07-0290
6. Dolgova I.G., Malishevskaya T.N., Lazareva A.S. Compliance and the patient's school: solving a common problem. Glaucoma. 2009;3:35-41
7. Egorov E.A., Lovpache J.N., Kharkovskiy A.O. Compliance—what is behind this term? breast cancer. Clinical ophthalmology. 2008; 3:84-86
8. Kazanova S.Yu. Analysis of treatment adherence in chronic disease patients. National Journal glaucoma. 2018;17(3):97-110. (In Russ.) https://doi.org/10.25700/NJG.2018.03.11
9. Kuroyedov A.V. Compliance in the therapy of a glaucoma patient. Moscow: GEOTAR-Media; 2017, – 364.
10. Vaughan D., Asbury T., Riordan–Eva P., «General Ophthalmology»,15th Edition, Appleton & Lange, Stamford, Connecticut, 1999.
11. Wise JB, Witter SL «Argon laser therapy for open–angle glaucoma: a pilot study», Archive of Ophthalmology and Glaucoma, 1979; 97, стр.319–322.
12. Nguyen A.T., Maslin J.S., Noecker J.R. Early results of micropulse trans-scleral cyclophotocoagulation for the treatment of glaucoma. Eur. J. Ophtalmol. 2019: 303. https://doi.org/10.1177/1120672119839303
13. Varikuti VNV, Shah P, Rai O, et al. Outcomes of Micropulse Transscleral Cyclophotocoagulation in Eyes With Good Central Vision. J Glaucoma. 2019;28(10):901-905. doi:10.1097/IJG.0000000000001339
14. Lovpache. J. N., Zavadsky P. Ch., Zvereva O. G., Kuroyedov A. V. et al. Compliance and persistence in patients with primary open-angle glaucoma through the doctor opinions. National Journal glaucoma. 2020;19(2):11-21. (In Russ.) https://doi.org/10.25700/NJG.2020.02.02
15. Quigley HA, Jampel HD. How are glaucoma patients identified?. J Glaucoma. 2003;12(6):451-455. doi:10.1097/00061198-200312000-00001
16. Sanchez F.G., Lerner F., Sampaolesi J., Noecker R. et al. Efficacy and Safety of Micropulse(R) Transscleral Cyclophotocoagulation in Glaucoma. Arch Soc Esp Oftalmol. 2018;93(12):573-579. doi: 10.1016/j.oftal.2018.08.003
17. Aquino MC, Barton K, Tan AM, et al. Micropulse versus continuous wave transscleral diode cyclophotocoagulation in refractory glaucoma: a randomized exploratory study. Clin Exp Ophthalmol. 2015;43(1):40-46. doi:10.1111/ceo.12360
18. Grippo M.T., Sanchez G.F., Stauffer J., Marcellino G. MicroPulse® Transscleral Laser Therapy – Fluence May Explain Variability in Clinical Outcomes: A Literature Review and Analysis. June 2021.Clinical ophthalmology (Auckland, N.Z.) Volume 15:2411-419.DOI:10.2147/OPTH.S313875
19. Latina M., Lachkar Y. Ranking Laser in Glaucoma Treatment. Jan/Feb 2021.Insert to glaucoma today
20. Ioshin I.,E., Tolchinskaya A.I. Maksimov I.V Rakova A.V. Experience of repeated micropulse cyclophotocoagulation in the treatment of patients with refractory glaucoma of various stages. National Journal of Glaucoma 2021, Vol. 20, № 3, pp. 30-39 National Journal of Glaucoma 2021, Vol. 20, № 3, pp. 30-39
21. Sarrafpour S., Saleh D., Ayoub S., Radcliffe N.M. Micropulse transscleral cyclophotocoagulation: A look at long-term effectiveness and outcomes. Ophthalmology Glaucoma. 2019; 2 (Issue 3 May-June): 167-71. https://doi.org/10.1016/j.ogla.2019.02.002
22. Al Habash A, AlAhmadi AS. Outcome of MicroPulse(®) transscleral photocoagulation in different types of glaucoma Clinical Ophthalmology (Auckland, N.Z.), 2019;(13):2353-2360
23. Magacho L, Lima FE, Ávila MP. Double-Session Micropulse Transscleral Laser (CYCLO G6) as a Primary Surgical Procedure for Glaucoma. J Glaucoma. 2020;29(3):205-210. doi:10.1097/IJG.0000000000001426
Supplementary files
|
|
1. Fig. 1. OCT of a patient with POAG Ib OS before mCPC. OD parameters of nerve fiber thickness are within normal limits. OS signs of GON: thinning of peripapillary fibers in the lower sector | |
| Subject | Рис.1 | |
| Type | Результаты исследования | |
View
(282KB)
|
Indexing metadata ▾ | |
|
|
2. Fig. 2. OCT of a patient with POAG IIb OD before mCPC. OD signs of GON: thinning of peripapillary fibers in the upper and lower sectors. OS early signs of GON: thinning of peripapillary fibers in the lower sector | |
| Subject | ||
| Type | Исследовательские инструменты | |
View
(287KB)
|
Indexing metadata ▾ | |
|
|
3. Graph 1. Changes in IOP after MP-TSCPC | |
| Subject | график | |
| Type | Результаты исследования | |
View
(60KB)
|
Indexing metadata ▾ | |
|
4. Сопроводительное письмо | |
| Subject | ||
| Type | Other | |
Download
(4MB)
|
Indexing metadata ▾ | |
Review
For citations:
Ioshin I., Tolchinskaya A., Rakova A., Maksimov I. Results of micropulse cyclophotocoagulation in patients with early stages of primary open-angle glaucoma. National Journal glaucoma. 2022;21(4).
Email this article 