Efficiency of Transscleral Micropulse Cyclophotocoagulation in Different Types of Glaucoma

Transscleral micropulse cyclophotocoagulation is a safe method for reducing ophthalmotonus, which has proven its effectiveness in various forms of glaucoma, including patients with high visual acuity.
Рurpose: to study the effectiveness of transscleral micropulse cyclophotocoagulation (MP-TSCPC) in various types of glaucoma.
Materials and methods. The data of 193 eyes of 192 patients with decompensated glaucoma (primary open-angle glaucoma, secondary glaucoma, neovascular glaucoma, including after IOL repositioning, primary angle-closure glaucoma) of various stages who underwent MP-TSCPC were analyzed. The observation period was up to 12 months. MP-TSCPC was performed on a Vitra A 810 device (Quantel Medical, France) with the following laser parameters: energy — W = 2000 mW, cycle exposure 31.3 %, total exposure time on four sectors — 160 sec.
Results. The MP-TSCPC is effective in POAG, where the IOP reduction was 32 % from the initial value by the end of the observation period, as well as in PACG, where the reduction by the end of 6 months was 51–56 % from the initial values. In secondary glaucoma by the end of the observation period — 37.5 % of the initial IOP, but without achieving the target values, including in neovascular glaucoma — 29 %. The total effectiveness of MP-TSCPC in the POAG group was 76.5 %, secondary glaucoma — 61.5 %, PACG — 100 %, neovascular glaucoma — 70 %, after IOL repositioning — 76.5 %. At the same time, no difference in effectiveness was found between the groups (p = 0.117). MP-TSCPC is more effective in advanced glaucoma, where by the end of the observation the hypotensive effect was 40 % of the initial value, and in advanced glaucoma, where it was 38 % of the initial one. The total effectiveness of MP-TSCPC in the advanced glaucoma group was 73.3 %, in advanced glaucoma — 80.3 %, in terminal glaucoma — 75 %, with no difference in effectiveness between the groups (p = 0.938). After MP-TSCPC, the number of drops of local hypotensive therapy decreased from 3.09 ± 0.6 to 2.95 ± 0.67 (p = 0.011). When performing MP-TSCPC to relieve pain in 43 eyes, the result was achieved in all cases.
Conclusion. MP-TSCPC has proven to be an effective and safe intervention for various types of glaucoma, with maximum effectiveness in the case of POAG and PACG at early and advanced stages. In various types of secondary glaucoma, the hypotensive effect is pronounced and persistent, but in a greater number of eyes without achieving compensation. Also, MP-TSCPC can be recommended for pain relief and reducing the drug load.

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