Resultados del mundo real de la ciclofotocoagulación con láser micropulsado en una población latinoamericana y análisis de los factores asociados con la tasa de éxito

Abstract

ObjectiveTo report the outcomes of micropulse cyclophotocoagulation in a Latin American population with refractory glaucoma in a «real-world» setting and to evaluate the factors associated with success after a one-year follow-up. Materials and methodsRetrospective, multicenter study. The medical records of patients who underwent micropulse cyclophotocoagulation between September 2017 and October 2018 were reviewed. Treatment success was defined as an intraocular pressure of 5-21mmHg or a 20% intraocular pressure reduction with or without additional glaucoma medical therapy. ResultsEighty-three eyes from 83 patients were included, with a mean follow-up of 10.1 ±3.1months. The intraocular pressure and number of glaucoma medications significantly decreased at all postoperative visits from a mean of 21.9 ±7.6mmHg on 3.8 medications to 13.1 ±3.5mmHg on 2.8 medications at the 12-month follow-up. The mean intraocular pressure decreased 40.1% from baseline at 12months. The cumulative success rate was 54.5% (95% CI: 44%-67%) at 12-month follow-up. We identified a higher baseline intraocular pressure as a significant independent predictor of treatment success (P=.03). Late complications included 1eye with corneal edema, 1eye with prolonged anterior chamber inflammation and cystoid macular edema and 9eyes (11%) with visual loss of 2Snellen lines or more. ConclusionsMicropulse cyclophotocoagulation is an effective and safe treatment for Latin American patients and can provide intraocular pressure and medication reductions with a single treatment after a one-year follow-up. A high baseline intraocular pressure was the most significant predictor of treatment success.