Experience of micropulse transscleral cyclophotocoagulation in glaucoma with decompensated intraocular pressure

PURPOSE. To evaluate the effectiveness of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in patients with decompensated glaucoma.

METHODS. The analysis included a total of 54 eyes with decompensated glaucoma that underwent MP-TSCPC. The mean age was 62.83±1.75 years. The follow-up period lasted up to 3 months. Advanced-stage glaucoma was observed in 18 eyes, and terminal-stage glaucoma in 34 eyes. Primary glaucoma was present in 37 eyes, and secondary glaucoma in 14 eyes. A reduction in intraocular pressure (IOP) of more than 20% from baseline was considered a successful outcome.

RESULTS. The baseline IOP was 38.97±1.94 mm Hg, with an overall hypotensive effect of 26%. The overall effectiveness of mCPC was 75.9%.

In terminal-stage glaucoma, IOP reduction by the end of the third month after MP-TSCPC was 23%, with an effectiveness of 76.5%. In advanced-stage glaucoma, IOP decreased by 16% by the end of the third month, with an effectiveness of 75%.

For primary glaucoma, the IOP reduction at 3 months was 32.5%, and for secondary glaucoma, it was 22%. Prior to MP-TSCPC, patients had been using an average of 3.075 types of eye drops, which remained unchanged after the procedure. The effectiveness of MP-TSCPC did not differ between operated and non-operated eyes. When MP-TSCPC was performed to relieve pain, success was achieved in all cases. During the study period, one patient underwent a repeat MP-TSCPC, and another underwent an antiglaucoma filtering surgery. No complications were observed in any of the cases.

CONCLUSION. MP-TSCPC is an effective intervention with a safe early postoperative period. We observed a significant hypotensive effect in eyes with preserved visual function and effective pain relief. Further follow-up of these patients is necessary, as well as the expansion of indications for use in earlier stages.

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