Experience of micropulse cyclophotocoagulation for treatment patients with early stages of glaucoma

Abstract

Aim to evaluate the efficacy and safety of micropulse transscleral cyclophotocoagulation (MP-TSCPC) modality in patients with early stages of glaucoma.
 Material and methods. We examined 38 patients with early stage of primary open-angle uncompensated glaucoma (POAG) (17 patients with early stage, 18 patients with advanced stage) before and during 12 months after the MP-TSCPC treatment (SUPRA device 810, Quantel Medical, France) using the modified laser parameters - power W=2000 MW, 31.3 % - exposure cycle, total treatment time in 4 sectors - 200 s, the total energy 125 J. Fluence - 121.8 J/m.
 Results. There were no complications after the procedure. In all patients, BCVA did not change during the observation period. A decrease in IOP was achieved in all patients. In 6 months of follow-up, the level of IOP remained stable and averaged 15.5 4.5 mm Hd. Up to 12 months of follow-up, the hypotensive effect persisted up to 31% of the initial IOP, which averaged 16.0 3.5 mm Hg. As a result, the persistent hypotensive effect helped to reduce the number of IOP-lowering medications in general, and to cancel them in 6 cases of 17 patients with early stage glaucoma.
 Conclusion. MP-TSCPC modified protocol showed high efficiency (up to 31% of the initial value during the year) in reducing the intraocular pressure in patients with early stages of glaucoma. The use of MP-TSCPC in patients with high visual acuity demonstrated a good safety profile due to areactive postoperative period. Further monitoring of patients after MP-TSCPC is necessary to develop practical recommendations for indications and regimens.