Micropulse Cyclophotocoagulation Research Articles

Применение микроимпульсной транссклеральной циклофотокоагуляции в лечении глаукомы. Предварительные результаты

Objective. To evaluate the preliminary results after micropulse cyclophotocoagulation in patients with primary open-angle refractory glaucoma (POAG) and neovascular glaucoma. Methods. Retrospective study of adult patients with glaucoma, with at least 6 months follow-up after the only one session of micropulse laser therapy. The study included 16 patients, 17 eyes with refractory primary open-angle glaucoma (POAG) and neovascular glaucoma. Follow up period was 6 months. The same surgical technique was used in all cases. The wavelength of the laser beam was 810 nm, the total exposure was 160 s, the energy was 2000 mJ, 31,3% of active cycle, the pulse duration was 0.5 ms, the period was 1.1 ms. Results. The average decrease in IOP was 26.6%. No complications identified Conclusions: micropulse transscleral cyclophotocoagulation has been shown to be safe and effective in lowering IOP in patients with refractory glaucoma. However, further study of this method is required. Key words: micrоpulse transscleral cyclophotocoagulation, glaucoma, intraocular pressure.

Сравнение эффективности транссклеральной лазерной циклофотокоагуляции в непрерывном и микроимпульсном режимах в лечении терминальной глаукомы

The article evaluates the effectiveness of classical transcleral laser cyclophotocoagulation in continuous mode and micro-pulse cyclophotocoagulation in the treatment of terminal glaucoma. There were 84 patients under observation. In the transcleral laser cyclophotocoagulation group, 6 months after the operation, the average IOP decreased below the baseline by 31.6%, while the micro-pulse cyclophotocoagulation decreased by 22.9%. In the early postoperative period, there were no complications in any case in the micro-pulse cyclophotocoagulation group, and in 3 patients in the transcleral laser cyclophotocoagulation group. Key words: terminal glaucoma, transcleral laser cyclophotocoagulation, micro-pulse cyclophotocoagulation.

Первый опыт применения микроимпульсной циклофотокоагуляции в комплексном лечении острого приступа закрытоугольной глаукомы

Purpose. To study effectiveness of micropulse cyclophotocoagulation (MP-CPC) in complex treatment acute angle closure glaucoma (ACG). Material and methods. Dynamic observation of 4 patients with acute ACG was carried out. There was stagnant injection of the conjunctiva, corneal edema, shallow anterior chamber, iris bombe, mydriasis up to 4–6 mm, closed anterior chamber angle in all quadrants. In three cases, the initial lens opacities were determined, in one eye the lens was transparent. Against the background of drug therapy and laser iridectomy, the intraocular pressure (IOP) level reached values from 26 to 33 mm Hg. On days 2–3 after admission to the hospital, all patients underwent MP-CPC using the Cyclo G6 Glaucoma Laser System the MicroPulse P3 glaucoma device (Iridex, USA). Results. The operation and postoperative period were uneventful. All patients had pain relief, inflammatory response was absent. Corneal edema was stopped 1–2 days after surgery. In all eyes, on the first day after the operation, there was significant decrease in IOP level to 14–23 mm Hg. One month after the complex treatment, the IOP level remained stably normal and ranged from 16 to 21 mm Hg in all patients. Increase in visual acuity was noted in all cases. Conclusion. MP-CPC is effective, safe and low-traumatic operation and can be used in complex treatment of patients with an acute ACG. Key words: micropulse cyclophotocoagulation, acute angle closure glaucoma, intraocular pressure.

Various modalities of cyclodestruction in non-refractory glaucoma: a comparative study.

The aim of the study is to study the safety and efficacy of three cyclodestructive treatments; high-intensity focused ultrasound (HIFU) cyclocoagulation versus micropulse cyclophotocoagulation (MP-CPC) versus transscleral continuous-wave cyclophotocoagulation (CW-CPC) for treatment of non-refractory glaucoma. This is a prospective comparative single-center study. Thirty non-refractory, medically uncontrolled, primary open-angle glaucoma patients with good vision were randomized to a single session of HIFU, MP-CPC or CW-CPC. Intraocular pressure (IOP) reduction, number of medications, success rate, visual acuity and complications were compared between the three groups. Success was defined as an IOP reduction of 30% and IOP between 6 and 21mmHg with or without medications, in the absence of vision-threatening complications. Thirty patients were enrolled in our study: 10 patients received HIFU, 10 patients received MP-CPC and 10 patients received CW-CPC. At 6months, IOP was reduced by 31.5%, 23.9% and 19.4% (P = 0.4) achieving a success rate of 50%, 60% and 50% (P = 0.8) for continuous, micropulse and HFU groups, respectively, with reduction in the number of drops and stop of oral acetazolamide. Although the difference in the rate of complications between groups was not significant, CW-CPC group had more complications. Cyclophotocoagulation could be an option in the treatment of non-refractory glaucoma even in patients with good visual acuity, with similar outcomes between the three types of cyclodestruction.

The Results of Transscleral Diode Laser Cyclophotocoagulation in Micropulse Mode Treatment in Patients with Primary Subcompensated Open-Angle Glaucoma and Toxic-Allergic Syndrome of the Ocular Surface

Purpose: to analysis the results of microimpulse transscleral diode laser cyclophotocoagulation (DCPC) technique as a method of choice in patients with open-angle subcompensated glaucoma (OAG) with toxic allergic syndrome of the ocular surface (TASOS).Methods. The retrospective analysis of patients’ case reports with subcompensated open-angle glaucoma and TASOS was performed. Transscleral diode laser cyclophotocoagulation (DCPC) in a microimpulse mode was used in their treatment. A total of 19 patients’ case reports were analyzed.Results. In the postoperative period, its course, patient’s complaints, ophthalmological status, visual acuity indicators were determined. The level of intraocular pressure was measured. Almost all patients (84.2 %) reached the target level of IOP. The frequency of side effects was low. In 36.84 % of patients, symptoms of TASOS decreased in response to hypotensive treatment due to reduction of instillation frequency.Conclusion. The use of micro-pulse cyclophotocoagulation in patients with subcompensation form of OAG and toxic-allergic ocular surface syndrome (TASOS) reduces the intensity of the drop regime of antihypertensive drugs. As a result, the manifestations of TASOS are reduced, which increases the patients’ quality of life in the postoperative period. In addition, the use of DCPC in microimpulse mode leads to stabilization of functional and structural indicators, helps to prevent a decrease in visual functions. Thus, the described method is characterized by safety, high efficiency and a wide range of indications for its performance. It allows to compensate the IOP with a minimum percentage of complications and stable postoperative results.

One-Year Follow-up of Pars Plicata Versus Pars Plana Application of Transscleral Micropulse Cyclophotocoagulation.

To compare the efficacy and safety of micropulse transscleral cyclophotocoagulation applied at the level of the pars plicata transscleral micropulse cyclophotocoagulation (PLI-MPC) versus the pars plana transscleral micropulse cyclophotocoagulation (PLA-MPC). This prospective interventional case series included 44 eyes of 31 medically treated primary open-angle glaucoma patients scheduled for micropulse transscleral cyclophotocoagulation to achieve further intraocular pressure (IOP) reduction. In total, 22 eyes underwent PLI-MPC and PLA-MPC each. Primary endpoints were the reduction of 24-hour mean diurnal IOP (mean of 6 measurements), diurnal IOP fluctuations, and peak IOP, after 3 and 12 months. Secondary outcomes were postoperative complications, a possible deterioration in visual acuity and field, factors influencing IOP reduction, and the number of dropouts. In the PLI-MPC group, IOP was reduced from 15.9±3.4 mm Hg to 13.6±3.1 mm Hg (n=16; P<0.001) and 12.9±3.7 mm Hg (n=13; P<0.001) at 3 and 12-month follow-up. In the PLA-MPC group, IOP decreased from 16.4±3.5 mm Hg to 12.3±2.6 mm Hg (n=15; P<0.001) and 11.8±2.2 mm Hg (n=14; P<0.001), respectively. At 12 months, 59% of the PLI-MPC and 63% of the PLA-MPC group had a sufficient IOP reduction to reach the individual target pressure. No complications were seen in either group. A higher preoperative IOP was recognized as the only factor influencing the postoperative IOP reduction. PLI-MPC and PLA-MPC seem to be safe and effective in further lowering the IOP in about 60% of patients with primary open-angle glaucoma who did not reach target pressure despite maximally tolerated IOP-lowering medication. Although the IOP-lowering effect was not statistically significantly different between groups the pars plicata application was superior and easier to perform and should be recommended as the preferred method of application.

Micropulse trans-scleral cyclophotocoagulation: treatment outcomes of refractory glaucoma in Malaysia

Introduction: A more novel form of cycloablation, micropulse cyclophotocoagulation (MPCPC), has gained popularity in recent years due to its proven efficacy in lowering intraocular pressure (IOP) as well as higher safety profile compared to conventional trans-scleral cyclophotocoagulation.&#x0D; Purpose: The aim of this study was to investigate the treatment outcome of MPCPC as an adjunctive treatment for refractory glaucoma.&#x0D; Study design: Retrospective interventional case series.&#x0D; Materials and methods: Subjects were patients with refractory glaucoma and glaucoma progression; with or without prior glaucoma surgery, who were not keen or not suitable for glaucoma surgery. Outcomes were IOP-lowering effect and reduction of glaucoma medications at 6 months follow-up. Treatment success was defined as either achieving IOP &lt; 21 mmHg or IOP reduction of 20% from baseline IOP.&#x0D; Results: The median age of patients was 57.5 years. A total of 34 eyes of 24 patients were treated with MPCPC with a mean follow-up period of 6 months. The majority of our patients (79%) experienced mild to moderate pain during the procedure. The median IOP prior to MPCPC was 30 mmHg and was significantly reduced at 1 week (17.5 mmHg), 1 month (17.5 mmHg), 3 months (21.0 mmHg), and 6 months (21.0 mmHg), with a 19.2% IOP reduction at the last follow-up. There were no cases of hypotony. The reduction in the number of glaucoma medications was not statistically significant. Our treatment success rate after a mean of 1.1 treatment sessions was 53% (16 out of 34 eyes).&#x0D; Conclusions: Our study showed that MPCPC offers good IOP-lowering efficacy and patient tolerability in the treatment of refractory glaucoma. Larger, prospective, comparative studies are needed to determine a standardized MPCPC treatment protocol with high success and low complication rates.

Эффективность лечения пациентов на разных стадиях глаукомы с помощью микроимпульсной циклофотокоагуляции

Эффективность лечения пациентов на разных стадиях глаукомы с помощью микроимпульсной циклофотокоагуляции

Микроимпульсная циклофотокоагуляция в лечении рефрактерной глаукомы у детей

Микроимпульсная циклофотокоагуляция в лечении рефрактерной глаукомы у детей

Micropulse Cyclophotocoagulation: A Multicenter Study of Efficacy, Safety, and Factors Associated With Increased Risk of Complications.

The purpose of this study was to evaluate the efficacy and complications of MPCP in a large series of patients with all stages of glaucoma. Multicenter, retrospective chart review of patients from 3 clinical sites. One hundred sixty-seven eyes of 143 patients. MPCP was performed with 2000 mW energy, 31.3% duty cycle and 2 to 4 180-degree applications of 80 seconds duration each per treatment. The procedure was considered a failure if any of the following occurred: additional IOP lowering intervention, <20% IOP reduction from baseline at the last follow-up (with or without medication), or severe complications. Mean age was 71 years, 53% were female, and 53% were Asian. 60% of eyes had POAG, 63% were pseudophakic, 38% had prior glaucoma surgery, and 51% had Snellen visual acuity (VA) of 20/40 or better. Mean follow-up time was 11.9±7.8 months. Mean IOP was 21.9±8.4 mm Hg before intervention, and 17.4±7.2 mm Hg at last follow-up (P<0.0001). There was no change in mean logMAR VA (P=0.0565) but 15% lost ≥3 Snellen lines of VA. The success rate was 36.5% (61/167 eyes) at last follow-up. The probability of survival by Kaplan-Meier analysis was 82%, 71%, and 57% at 3, 6, and 12 months after the procedure, respectively. The reasons for failure were additional intervention in 47%, inadequate IOP reduction in 14%, and severe complication in 1.8%. In a multivariable Cox proportional hazard model, female sex was associated with a 56% decrease in failure rate compared with males (P<0.0001), while a unit increase in baseline IOP corresponded with a 5.7% increase in failure rate (P<0.0001). If repeat MPCP was allowed then success rate increased to 58%. There were no complications in 73% (122/167) but 11% (18/167) had persistent complications at the last follow-up and half of these 18 eyes had decrease in VA of 1 to 6 Snellen lines. Asian race (odds ratio 13.5, P=0.0131) and phakic status (odds ratio 3.1, P=0.0386) were associated with higher odds of developing mydriasis, which was the most common complication. MPCP lowered IOP in the short-term but nearly half required additional IOP lowering intervention. Potential complications should be discussed in detail especially when the procedure is being considered for those with good VA and early stage disease.

Our experience with micropulse cyclophotocoagulation in the therapy of glaucoma.

The cohort of patients consisted of 47 people, out of which 16 men and 31 women. An average age of males was 58.9 years (the range from 35 to 78 years), and an average age of females was 64.7 years (the range from 33 to 86 years). Both eyes were treated in three patients, and therefore the total number of assessed eyes was 50. Patients who underwent the therapy were in different stages of glaucoma disease, with various types of primary and secondary glaucoma. Most of the patients were those with primary open angle glaucoma (POAG): 26 patients, followed by patients with secondary pseudoexfoliative glaucoma (PEXG): 9 patients; diagnoses of the remaining patients: 4 patients - secondary pigmentary glaucoma (PG), 3 patients - primary angle closure glaucoma (PACG), 2 patients normal tension glaucoma (NTG), 3 patients - Posner-Schlossman syndrome, 1 patient - Cogan-Reese syndrome, 1 patient - neovascular glaucoma and 1 patient - secondary traumatic glaucoma. On the operated eye prior to the surgery 3 patients underwent laser iridotomy, 4 patients trabeculectomy, 4 patients EX-PRESS® implant, 3 patients EX-PRESS® implant and trabeculectomy and 1 patient transscleral cyclophotocoagulation. During surgery we opted for from 2,000 to 2,250 mW infrared laser with 810 nm wavelength which uses amicropulse system of laser energy emission. For the procedure we used anew MP3 application probe. 30% drop in intraocular pressure (IOP) compared to the baseline IOP values was set as asuccess. Our results correlated with the most of available studies when we achieved drop in the values of intraocular pressure by the minimum of 30% in 53.4% of the eyes. The effect of therapy failed in 9 eyes (18%) where we subsequently selected adifferent therapeutic procedure. MP CPC is anon-incisional laser treatment with minimum complications. It is characterized by ahigh safety profile and predictability of results. In our study we achieved drop in the values of intraocular pressure by the minimum of 30% in 53.4% of treated eyes. Its use is not limited by the type of glaucoma disease. In the event of insufficient effect, it may be repeated.

The Effectiveness and Safety of Micropulse Cyclophotocoagulation in the Treatment of Ocular Hypertension and Glaucoma

To evaluate the effectiveness and safety of primary and adjunctive micropulse cyclophotocoagulation (MPCPC) in the treatment of ocular hypertension (OHT) and glaucoma. Retrospective cohort study. Ocular hypertension and all severities of glaucoma (including treatment-naïve and well-sighted eyes) and all types of glaucoma (including normal-tension glaucoma [NTG]). Consecutive eyes with glaucoma or OHT that underwent MPCPC (Iridex Cyclo G6 Glaucoma Laser System, Mountain View, CA) between 2016 and 2018 were identified. Intraocular pressure (IOP), visual acuity, glaucoma medications, and ocular adverse events. Three hundred ninety-nine MPCPC surgeries, on 342 eyes of 214 patients, were analyzed. Laser power ranged from 900 to 2800 mW. Main diagnoses in descending prevalence were primary open-angle glaucoma (55.9%), chronic angle-closure glaucoma (10.8%), neovascular glaucoma (9.0%), NTG (6.5%), and OHT (5.5%). Mean baseline IOP was 19.8±7.4 mmHg and IOP reduction was 22.7%, 20.2%, 20.7%, and 23.7% at postoperative months (POMs) 1, 3, 6, and 12 (P < 0.0001 for all time points). The end point of 20% or more mean IOP reduction from baseline was achieved by 67.8% of the study cohort at POM 12. Additional mean IOP reduction of 16.4% (P < 0.0001) was achieved with each re-treatment. Analysis based on IOP stratification demonstrated 30.5% mean IOP reduction at POM 12 when baseline IOP was more than 21 mmHg and 20.1% when it was 21 mmHg or less (71% of overall cohort; P < 0.0001). Analysis based on laser power stratification demonstrated mean IOP reduction of 31.5% at POM 12 with laser power of 2500 mW or more and 17.8% with laser power of less than 2500 mW (P < 0.02). Overall, the mean number of topical glaucoma medications was unchanged from baseline to POM 12. Greater baseline IOP and number of baseline topical glaucoma medications were significant predictors of effectiveness in the regression analysis. No patients demonstrated persistent inflammation or hypotony, phthisis bulbi, or sympathetic ophthalmia. In patients with OHT or glaucoma, MPCPC demonstrated effectiveness and safety in IOP reduction sustained to 1 year. Baseline IOP of 21 mmHg or less subgroup demonstrated a more limited response. A dose-response relationship is suggested with respect to laser power and repeat treatments.

Микроимпульсная циклофотокоагуляция в комбинированном лечении неоваскулярной глаукомы

Introduction. Neovascular glaucoma (NVG) is one of the most prognostically unfavorable forms of the glaucomatous process. The leading pathogenetic mechanism for the development of NVH is hypoxia of the inner layers of the retina, leading to the development of endothelial vascular growth factors (VEGF), which induce neovascular proliferation. In the presence of newly formed vessels in the corner of the anterior chamber, the use of traditional surgical methods for treating glaucoma is limited. That is why the search for a new pathogenetically oriented methods for the treatment of NVH is still acute issue in ophthalmology. Purpose. To evaluate the preliminary results of combined treatment, including intraocular introduction of anti-VEGF therapies (ranibizumab) and micropulse cyclophotocoagulation, in patients with secondary neovascular glaucoma. Materials and methods. The study included 15 patients (15 eyes) with secondary neovascular glaucoma. The value of intraocular pressure (IOP) before surgery ranged from 28 to 44 mm Hg. (average 36.3 ± 4.4 mm Hg), the number of hypotensive drops was 3.5 ± 0.5. The combine treat of patients including the intraocular administration of a VEGF inhibitor (ranibizumab) and through 7-14 days transscleral diode-laser cyclophotocoagulation in micropulse mode on the device «Cyclo G6 Glaucoma Laser System» (IRIDEX, USA) with a laser power of 2000 mW, an exposition of 160 s (80 s in each hemisphere) and a duty cycle of 31.3%. Results. All treatment procedures were performed without complications. By 6 months of follow-up, the average IOP level was 26.9 ± 3.3 mm Hg, the number of hypotensive drops was reduced to 2.7 ± 0.7 drugs. By 1 month of observation, a decrease in the number of newly formed vessels of the iris was achived in all patients. According to ultrasound biomicroscopy, the thickness of the ciliary body (CT) before treatment was on average 0.58 ± 0.14 mm. By 6 months of follow-up, no cases of postoperative atrophy of CT was diagnosed, the thickness of the CT was on average 0.53 ± 0.11 mm. According to the data of optical coherence tomography in the angiography mode, in all cases there was a positive dynamic in 1 month after combined treatment - a significant decrease in macular edema, the area of the retinal nonperfusion zone and the number of newly formed vessels. Conclusion. Combined treatment of patients with secondary neovascular glaucoma, including intraocular introduction of anti-VEGF therapies and micropulse cyclophotocoagulation, is an effective and safe method for reducing IOP.

Micropulse diode cyclophotocoagulation: A review of the literature

Transscleral diode cyclophotocoagulation (CPC) has conventionally been reserved for refractory glaucoma, where other surgery is not feasible. The newer micropulse cyclophotocoagulation (mpCPC) has become popular in recent times and is increasingly being used as a primary surgery for glaucoma in eyes with good vision. The available literature on mpCPC and its mechanism, histological changes caused in the eye, the technique of usage, efficacy, safety, potential applications, and comparison with continuous wave CPC and other surgeries have been reviewed. Varying criteria for inclusion and different definitions of success in studies make a direct comparison between studies difficult. The lack of definite evidence to prove superiority of mpCPC and the potential for rare but reported sight threatening complications should be kept in mind, especially before using this in nonrefractory cases of glaucoma when other time tested options are available.

Combined Technique for the Application of Micropulse Cyclophotocoagulation in Patients with Uncontrolled Glaucoma: Cyclo Mix.

PurposeTo describe the outcomes of a combined technique (Cyclo Mix) in uncontrolled glaucoma cases.Materials and methodsRetrospective study. The Supra 810 nm subliminal laser (Quantel Medical, Cournon d'Auvergne, France) was used. A combined technique was performed using the subliminal mode (Subcyclo) in one hemifield (power of 2,000 mW, a duty cycle of 35%, and 80–150 seconds), and the continuous wave mode (Thermo Cyclo) on the other hemifield (power of 1,000 mW, exposure time of 2 seconds per spot). The primary endpoint was the probability of surgical failure. Mean intraocular pressure (IOP) change, best-corrected visual acuity (BCVA), number of glaucoma eye drops, and complications at 6 months postoperatively were secondary outcomes.ResultsTwenty-three eyes from 13 patients were included. Mean age was 61.4 ± 16.7 (range: 18–78 years), and 69% were female, with a baseline IOP of 20.3 ± 5.9 (range: 13–38 mm Hg). The cumulative probability of failure was 18 and 22% on days 90 and 180, respectively. Mean IOP reduction was −25.6 ± 20.9% at 6 months. The number of glaucoma eye drops was reduced to 1.2 ± 1 (p = 0.0024) at 6 months. No statistically significant change in the mean BCVA compared with baseline at 6 months was found (p = 0.84), and no severe complications were reported.ConclusionCyclo Mix seems to be a safe therapy that effectively reduces the IOP and glaucoma medications in eyes with uncontrolled open-angle glaucoma for up to 6 months.How to cite this articleWaldo L-G, Julio H-Q, Jennifer C-V, et al. Combined Technique for the Application of Micropulse Cyclophotocoagulation in Patients with Uncontrolled Glaucoma: Cyclo Mix. J Curr Glaucoma Pract 2020;14(3):93–97.

MicroPulse Cyclophotocoagulation Innovation in the Treatment of Glaucoma

MicroPulse Cyclophotocoagulation Innovation in the Treatment of Glaucoma

Современный взгляд на циклодеструктивные операции при глаукоме

The main purpose of glaucoma treatment is to reduce the intraocular pressure (IOP) to a target level. One of the pathogenetically justified method of treatment for various types of glaucoma, first of all its refractory forms, is the surgery on the ciliary body. A purpose of such manipulations is to suppress excessive formation of aqueous humor. Previously, diode laser cyclophotocoagulation was widely used, which is mainly applied in terminal glaucoma. Technological innovations have led to the development of perspective, more safe, and less destructive methods of cyclodestructive anti-glaucomatous operations, such as micro-pulse diode cyclophotocoagulation, endoscopic cyclophotocoagulation, and ultrasound cyclodestruction. During micro-pulse cyclophotocoagulation, the effect of laser energy occurs by short pulses at rest intervals, which significantly reduces the absorption of energy by surrounding tissues and their associated damage. With endoscopic cyclophotocoagulation, the epithelium of the ciliary processes is directly coagulated, which makes it possible to dose laser energy under visual control. Ultrasonic cyclodestruction causes a coagulation necrosis of the ciliary processes with a very insignificant collateral damage of surrounding tissues. Today these surgical techniques are becoming more relevant in the treatment of refractory glaucoma in order to preserve visual functions. This review is an analysis of modern literature, reflecting the efficacy and safety of cyclodestructive operations with sufficiently high visual functions.

Микроимпульсная лазерная циклофотокоагуляция в лечении врожденной глаукомы. Клиническое наблюдение

The article presents a clinical case of a patient with congenital operated glaucoma with residual visual functions, who was treated with micropulse cyclophotocoagulation. Presents early and long-term results.

Micropulse Versus Continuous Wave Transscleral Cyclophotocoagulation in Refractory Pediatric Glaucoma.

The aim of this study was to compare the safety and efficacy of micropulse cyclophotocoagulation (MP-CPC) and transscleral continuous wave cyclophotocoagulation (CW-CPC) for the treatment of refractory glaucoma in the pediatric age group. This prospective study included 45 eyes of 36 children requiring transscleral cyclophotocoagulation, in the period spanning from September 2016 to August 2017, using micropulse (MP-CPC) or continuous wave (CW-CPC) modes. The intraocular pressure (IOP) reduction, success rates, and complications were compared for both groups. Success was defined as an IOP of 5 to 21 mm Hg, in the absence of vision-threatening complications at 6 months. The MP-CPC group included 17 eyes, in patients aged 67.8±48 months, and the CW-CPC group included 28 eyes, in patients aged 61.3±38.3 months. There was a tendency toward lower IOP in the MP-CPC group at all follow-ups, almost reaching statistical significance at 2 weeks and 3 months (P=0.05). IOP reduction was 63% in the MP-CPC group and 67% in the CW-CPC group (P=0.6). The success rate was higher in the MP-CPC group (71% vs. 46% in the CW-CPC group), but the difference was not significant (P=0.1). No significant complications were noted in the MP-CPC group whereas, in the CW-CPC group, 1 eye developed phthisis bulbi, and 2 eyes had severe pain and uveitis (P=0.3). Both the MP-CPC and CW-CPC are effective in lowering the IOP in children with refractory glaucoma. However, the rate of complications, pain, and inflammation seem to be lower with the micropulse mode, making it a safer alternative for cyclophotocoagulation, especially since retreatments are often needed.

Możliwości stosowania mikropulsowej cyklofotokoagulacji jako opcji leczenia pacjentów z różnymi postaciami jaskry

Możliwości stosowania mikropulsowej cyklofotokoagulacji jako opcji leczenia pacjentów z różnymi postaciami jaskry