Comparison of Efficacy of Micropulse Laser Settings for Glaucoma Management.

Abstract

Objectives: This study aims to compare micropulse transscleral cyclophotocoagulation (MP-TSCPC) laser parameters and determine the optimal laser setting. Methods: A retrospective study was performed on 351 eyes from patients who underwent MP-TSCPC at four power settings (1500 mW, 2000 mW, 2250 mW, and 2500 mW) from June 2018 to December 2021. The primary measurements of the efficacy of MP-TSCPC were the degree of intraocular pressure (IOP) reduction and the number of glaucoma medication reductions. The rate of hypotony was obtained to assess the safety of MP-TSCPC. Results: At 1500, 2000, and 2500 mW, the mean IOP reduction at each visit was statistically significant compared to the baseline, and at 2250 mW, the mean IOP was only significantly different at 18 months (p < 0.05). The change in the number of medications with 2000 mW has shown significance at 1 and 3 months from the baseline; with 2500 mW, statistical significance was shown at 3, 6, 12, and 18 months (p < 0.05) compared to the baseline. Mean IOP reductions (%) were greater in 2000 mW than in 1500 mW at 1 week, 1 month, and 3 months and were greater in 2500 than in 1500 mW at 1 week (p < 0.05). There was no significance for mean IOP reductions at 6, 12, and 18 months across all powers. Only two occurrences of hypotony were reported. Conclusions: MP-TSCPC at 1500 mW, 2000 mW, and 2500 mW is a safe and effective treatment for IOP reduction. MP-TSCPC at 2250 mW is safe but may show delayed effectiveness in IOP reduction. In the long term, no one specific power setting was found to be superior for IOP reduction.