Abstract
Glaucoma is the leading cause of irreversible blindness worldwide, with primary open angle glaucoma (POAG) accounting for the greatest number of total glaucoma cases. This study aimed to evaluate the efficacy and safety of micropulse transscleral cyclophotocoagulation (MP-TSCPC) as a primary procedure in POAG during the COVID-19 pandemic. We retrospectively analyzed 60 eyes of 52 patients, who were diagnosed with mild-to-end-stage POAG without previous glaucoma surgery and received MP-TSCPC between 1 January 2020 and 31 August 2020. The mean preoperative intraocular pressure (IOP) significantly decreased from 27.8 mm Hg to 19.8, 20.1, 20.3, 20.4, and 20.2 mm Hg at 1, 3, 6, 9, and 12 months, respectively (all p < 0.05). The mean number of IOP-lowering medications used significantly decreased from 3.3 at the baseline to 1.6, 1.8, 1.8, 1.9, and 1.9 at 1, 3, 6, 9, and 12 months, respectively (all p < 0.001). Total withdrawal of antiglaucoma medications was fulfilled in five patients. The main outcome was achieved in 81.7% at postoperative month 12. The most common adverse effect was transient mydriasis (28.3%). No major complications were encountered. MP-TSCPC seems to be an effective and safe treatment to reduce IOP and the medication burden with minimal vision-threatening complications in mild-to-end-stage POAG patients without previous glaucoma surgery.
Highlights
Glaucoma is the leading cause of irreversible blindness in the world [1]
We aimed to evaluate the efficacy and safety of MP-Transscleral cyclophotocoagulation (TSCPC) as a primary surgical treatment in mild-to-end-stage primary open angle glaucoma (POAG) in Taiwan during the COVID-19 pandemic
Fifty-six patients with POAG were treated with MP-TSCPC
Summary
Glaucoma is the leading cause of irreversible blindness in the world [1]. Asia alone accounts for more than half of total glaucoma cases worldwide and contains the greatest number of people with primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG) [2]. Evidence from clinical trials has demonstrated that intraocular pressure (IOP) is strongly correlated with the progression of glaucoma and is the only modifiable risk factor [3,4,5]. Lowering the IOP plays a crucial role in the management of glaucoma. While medications are generally used as the initial treatment, a large proportion of patients treated with topical medications have concurrent ocular surface disease [6,7]. Topical therapies harbor the predicament of poor adherence, which may contribute to suboptimal IOP control and visual loss [8,9]. Filtering surgery results in positive outcomes regarding IOP lowering, the risk of long-term complications, including hypotony, infectious endophthalmitis, and bleb-related complications, remains a concern [10,11]
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