Double-session micropulse transscleral laser (CYCLO G6) for the treatment of glaucoma.

Abstract

This study aims to evaluate the effectiveness and safety of double-session micropulse transscleral (MP3) laser for the treatment of glaucoma. This was a retrospective chart review of all patients who underwent MP3 laser with the standard protocol and were within at least 12months of their follow-up appointments. Eyes were treated at 2000mW with 31.3% duty cycle for 80s per treatment session, with double sessions in each hemifield alternating between upper and lower and upper and lower. Success criterion was defined as a greater than 20% reduction in intraocular pressure (IOP) and an IOP between 6 and 18mmHg at the end of the follow-up period. Eighty-nine eyes of seventy-six glaucoma patients were included; 31 of which were considered primary, i.e., no previous glaucoma surgery. The average pre-treatment IOP was 29.9 ± 6.4mmHg. At around 16.7 ± 3.1months of follow-up, the average IOP was 14.8 ± 4.7mmHg (p < 0.001) (28.8 ± 7.4 to 15.7 ± 5.3mmHg, p < 0.001, at 17.0 ± 3.1months in the primary eyes). The number of topical glaucoma medications was reduced from 3.6 ± 0.5 to 1.9 ± 0.9 at the last evaluation (p < 0.001). The best corrected visual acuity in logMAR ranged from 0.41 ± 0.34 preoperatively to 0.45 ± 0.44 at the last visit (p = 0.2), and also remained stable in primary eyes. Success was obtained in 86.5% of the eyes, with 1.5 ± 0.8 procedures, and in 90.3% with 1.2 ± 0.5 MP3 laser procedures in the primary eye group. MP3 laser in two consecutive 80-s sessions was shown to be safe and effective in the treatment of glaucoma. Primary eyes required lower number of MP3 laser procedures.