To evaluate the intraocular pressure (IOP)-lowering efficacy and treatment stability of ripasudil-brimonidine fixed-dose combination (RBFC) in patients with secondary glaucoma associated with uveitis. Single-center, retrospective study. Medical records of 50 eyes prescribed RBFC were reviewed and categorized into inflammatory ocular hypertension (OH; n = 19), steroid-induced OH (n = 18), and primary open-angle glaucoma (POAG; n = 13). Clinical parameters-including IOP, visual acuity (VA), and medication score-were assessed at baseline, the first follow-up, and the final visit. In the inflammatory and steroid-induced OH groups, mean IOP decreased significantly from baseline and remained stable throughout the observation period (P< 0.001). VA was maintained with a slight, non-significant improvement, and medication scores remained stable, indicating sustained treatment efficacy without additional eye drops. One mild case of conjunctivitis occurred in the POAG group. RBFC was associated with significant IOP reduction in eyes with uveitis-associated or steroid-induced OH, without compromising visual function. These findings suggest that RBFC may be a useful therapeutic option for inflammation-related secondary glaucoma.

Nanophthalmos is a rare developmental ocular disorder of congenital origin, manifesting as a notably reduced globe volume, shortened axial length, shallow anterior chamber, thickened sclera, and significant hyperopia. These anatomical features predispose affected individuals to angle-closure glaucoma as a result of anterior segment crowding. Traditional treatments for nanophthalmos-related angle-closure glaucoma often involve complex combined surgeries, which are not only technically demanding but also easily cause postoperative complications, such as malignant glaucoma and choroidal leakage. This case series presents three middle-aged and elderly female patients (a total of four eyes) with nanophthalmos-related angle-closure glaucoma. Common clinical findings included an axial length ≤ 20.5 mm, high intraocular pressure (IOP &amp;gt; 21 mmHg; 1 mmHg = 0.133 kPa), shallow anterior chamber, and diminished visual acuity. Based on the pathogenesis of postoperative malignant glaucoma, we implemented a modified surgical technique termed pars plana filtration (PPF). This procedure involves partial excision of the ciliary body to establish an alternative aqueous drainage route, thereby reducing anterior vitreous and posterior segment pressure. Compared to traditional combined surgeries, the PPF approach offers technical simplicity, minimized tissue invasiveness, and a shorter learning curve for ophthalmic surgeons. Our study describes successful implementation of this surgery without postoperative complications observed. These findings suggest that PPF may represent a safe and effective surgical alternative for managing nanophthalmos-related angle-closure glaucoma. Nevertheless, further larger-scale studies are needed to validate its long-term effectiveness and generalizability.

MYCN amplification occurs in a subset of retinoblastoma cases, both with and without RB1 inactivation. It has been suggested that retinoblastomas with MYCN amplification represent a distinct entity with more aggressive clinical behavior. We examined the incidence of MYCN gain/amplification and RB1 inactivation in 192 unilateral retinoblastoma samples from children enucleated between 2011 and 2018 at the German reference center. MYCN copy number was assessed using quantitative PCRand confirmed by single nucleotide polymorphism microarray analysis. Clinical characteristics, RB1 mutation status, and histopathological features were compared between MYCN-amplified and nonamplified retinoblastomas. MYCN gain/amplification was found in 10 of 139 retinoblastomas included in the final analysis (7.2%). All 10 tumors exhibited alterations in at least one RB1 allele (RB1-/- or RB1+/-). TheRB1mutation spectrum and overall genomic copy number changes were similar between MYCN-amplified and MYCN-nonamplified retinoblastomas. Age at diagnosis did not differ significantly between the two groups (p=0.21); however, secondary glaucoma, massive choroidal, and scleral invasion occurred more often in MYCN-amplified retinoblastomas (p=0.038, p=0.03, and p=0.04, respectively). No cases of extraocular retinoblastoma or distant metastasis were observed during a median follow-up of 50 months. MYCN gain/amplification was identified in 7.2% of enucleated unilateral retinoblastomas, all of which showedRB1inactivation. MYCN amplification was associated with more advanced disease and more aggressive clinical and histopathological features.

Ocular manifestations of transthyretin amyloidosis and their diagnostic value in cardiology: A comprehensive review.

Microspherophakia (MSP) is a rare crystalline lens development abnormality characterised by increased anteroposterior thickness and decreased equatorial diameter. It is connected with a variety of ocular and systemic diseases, the most serious of which is secondary glaucoma. Early identification, proper lens and glaucoma care, and adequate visual rehabilitation can all help to avoid glaucoma-related blindness. Because MSP mostly affects young people, a multidisciplinary approach with ongoing follow-up is strongly advised. The rarity of this illness has hampered the availability of large-scale prospective investigations, with current information primarily obtained from case reports and retrospective analysis. This makes the development of standardised treatment guidelines problematic. The purpose of this review is to examine the surgical aspects of managing MSP in young patients and to evaluate the associated visual outcomes. To alleviate zonular weakness, surgical treatment options include techniques such as lens extraction with or without Intraocular Lens (IOL) implantation, as well as more sophisticated approaches such as scleral-fixated IOLs, iris-claw lenses, and capsular tension devices. Recent research suggests that prompt surgical intervention can greatly improve visual acuity and overall quality of life in afflicted patients. Nonetheless, long-term treatment must include possible problems such as glaucoma, zonular instability, as well as IOL displacement. This review emphasises the significance of individualised surgical methods, coordinated multidisciplinary therapy, and long-term follow-up in achieving excellent visual results in young people with MSP. It also emphasises the importance of bigger prospective studies and the creation of standardised surgical guidelines for improving evidence-based clinical practice.

Longitudinal visual field and quality of life change in the Treatment for Advanced Glaucoma Study.

To assess real-world canaloplasty outcomes in glaucoma management using standardized data from an international registry. The iTrack Global Data Registry (iTGDR) is an ongoing prospective real-world multicenter observational study on ab-interno canaloplasty with the iTrack or iTrack Advance (Nova Eye Medical), with or without concomitant cataract surgery. Patients diagnosed with ocular hypertension or glaucoma (excluding angle-closure glaucoma). Analysis included eyes with a minimum 12 months follow-up from the iTGDR. Both standalone canaloplasty and canaloplasty combined with cataract surgery were included. Intraocular pressure (IOP) and glaucoma medications were assessed at baseline and postoperative follow-ups. Surgical success was defined according to the 2024 American Academy of Ophthalmology (AAO) criteria. IOP, number of glaucoma medications, and success rate at last follow-up (LFU). Two hundred and fifty-four patients (344 eyes) were followed over a mean of 20.5 ± 7.9 months (LFU). Following combined canaloplasty and phacoemulsification (n = 313 eyes), mean IOP and medication usage reduced from 17.2 ± 5.3 mm Hg and 2.1 ± 1.1 preoperatively to 14.1 ± 3.9 mm Hg and 1.3 ± 1.4 at LFU (P < .001); 61.9% of all combined eyes achieved success (increasing to 83% in eyes with baseline IOP > 18 mm Hg), while 43% of eyes became medication-free (vs 7% preoperatively). Standalone canaloplasty (n = 24 eyes) reduced IOP and medication usage from 20.2 ± 7.1 mm Hg and 2.3 ± 0.9 to 15.3 ± 6.3 mm Hg and 1.5 ± 1.6 (P < .01); 35% of eyes achieved success, and 46% of eyes became medication-free (vs none preoperatively). IOP and medication reductions were significant across glaucoma subtypes (primary and secondary open-angle glaucoma, ocular hypertension) and severities (P < .01 for all). The rate of additional glaucoma procedures was 4.9%, including laser procedures; no canaloplasty-related sight-threatening complications were reported. A loss of ≥2 lines of corrected distance visual acuity occurred in 7.3% of eyes, most commonly in association with pre-existing advanced disease or unrelated ocular comorbidities. In real-world clinical practice, iTrack canaloplasty significantly reduced IOP and medication burden with a favorable safety profile when performed alone or with phacoemulsification and in diverse glaucoma populations.

Von Hippel–Lindau (VHL) syndrome is a hereditary disorder predisposing patients to multiple vascular tumors, including retinal capillary hemangioblastomas (RCH), which may cause progressive vision loss if undetected or untreated. We describe a 31-year-old man with known VHL syndrome who presented with a blind, painful left eye following recurrent retinal detachments and secondary glaucoma despite multiple surgeries. Ophthalmic examination demonstrated no light perception, rubeosis iridis, and corneal degeneration. B-scan ultrasonography revealed total retinal detachment with an intraocular mass showing calcification, and orbital MRI demonstrated an enhancing intraocular lesion without extraocular extension. Systemic imaging excluded other VHL manifestations. Due to intractable pain and irreversible ocular damage, enucleation was performed. Histopathology confirmed a capillary hemangioblastoma composed of thin-walled vascular channels positive for CD31 and CD34. Genetic testing verified a pathogenic VHL mutation. Postoperatively, the patient achieved pain relief, with no recurrence or systemic involvement at two-year follow-up. This case illustrates advanced ocular complications of VHL-associated retinal hemangioblastoma and highlights the importance of early diagnosis, coordinated multidisciplinary management, and lifelong surveillance to prevent devastating visual outcomes.

PreserFlo® MicroShunt implantation alone may be well tolerated for the corneal endothelium across glaucoma subtypes over 12 months, whereas combination with cataract extraction may increase the risk of endothelial compromise, with a tendency toward a more pronounced reduction in pseudoexfoliation glaucoma. To evaluate the impact of PreserFlo® MicroShunt (PMS) implantation on corneal endothelial cell density (ECD) over 12 months, stratified by glaucoma subtype and surgical procedure. This retrospective cohort study included 103 eyes with primary open-angle glaucoma, pseudoexfoliation glaucoma (PEXG), and secondary open-angle glaucoma without PEXG, all undergoing PMS implantation (either alone or combined with cataract extraction [PMS-CE]) between August 2022 and December 2023. Changes in ECD, coefficient of variation (CV), and hexagonal cell percentage (HEX) were assessed. Firth logistic regression was employed to evaluate risk factors for >10% ECD loss. Subgroup analyses were performed by surgical procedure. No significant within-group ECD, CV, or HEX changes were observed at 12 months in any glaucoma subtype. Thirteen eyes (12.6%) exhibited >10% ECD loss, predominantly in the PMS-CE group. Multivariate analysis identified PMS-CE as a significant risk factor (odds ratio [OR]: 12.1; 95% confidence interval [CI]: 2.69-75.0; P <0.001). In the PMS-CE subgroup, PEXG was associated with greater risk of ECD loss (OR: 9.39; CI: 1.19-125.0; P=0.033). PMS-alone demonstrated a favorable safety profile for the corneal endothelium across glaucoma subtypes. However, PMS-CE may pose an elevated risk of endothelial compromise, with a tendency toward a more pronounced reduction in PEXG eyes.

A clinical case of exudative retinal detachment after trabeculectomy for secondary glaucoma with Sturge-Weber syndrome is presented. A 50-year-old female patient with Sturge-Weber syndrome sought help for secondary glaucoma with elevated intraocular pressure on maximum drug hypotensive therapy. According to these indications, she was offered trabeculectomy with posterior trepanation of the sclera. Surgical treatment was without intraoperative complications. However, in the early postoperative period flat choroidal detachment and widespread retinal detachment involving the macular region were detected. During observation and prescription of anti-inflammatory and cycloplegic therapy, resolution of the exudative process was noted 1 month after surgery. Conclusion. Despite the peculiarities of the postoperative course, trabeculectomy is one of the effective methods of surgical treatment of secondary glaucoma in Sturge-Weber syndrome.

Relevance. Secondary silicone-induced glaucoma (SIG) is one of the complications of prolonged tamponade of the vitreous cavity with silicone oil. Timely detection of early signs of silicone oil emulsification is a significant diagnostic tool for an ophthalmologist. Methods. This article represents a comparison of instrumental methods of patient’s examination aimed to identify signs of emulsification, reveals the strengths and weaknesses of various methods, formulates and illustrates signs indicating an active emulsification process in the eye, and analyzes the possible relationship between instrumental findings and clinical data. Results. Ultrasound biomicroscopy has become the most universal among instrumental examination Methods. Diagnostic capabilities of optical coherence tomography in the context of detecting a silicone oil emulsion are limited, applicable only to the posterior segment of the eye and only possible in conditions of transparent optical media. The most informative signs indicating a high risk of SIG are hyperechoicity of the structures of the ciliary apparatus (the flat part and its processes) and the angle of the anterior chamber (trabecular apparatus, Schlemm canal), as well as “ghost images”. Hyperoleon is sensitive, but probably a late sign of emulsification. When conducting research, the natural hyperechogenicity of the pigment leaf of the iris should be taken into account. Hyperechoic inclusions in the anterior chamber of the eye are not directly related to the risk of CIG, however, they indicate the emulsification process in general. Conclusion. Further investigation of methods for early detection of silicone oil emulsification will optimize patient management and reduce the incidence of secondary glaucoma.

This retrospective, single-center study aimed to determine the long-term real-world efficacy and safety of the MicroShunt over up to a 6-year period in a heterogeneous glaucoma population of 1001 eyes: including pseudophakic eyes and eyes undergoing combined cataract and MicroShunt surgery. Data were analyzed from 1001 eyes implanted with the MicroShunt between January 2019 and May 2025. The outcomes collected were intraocular pressure (IOP) reduction, complete and qualified surgical success at targets of 6-14, 6-18, and 6-21 mmHg, the medication burden, and the postoperative complications. Subgroup analyses compared all the eyes implanted with pseudophakic eyes or those undergoing combined cataract and MicroShunt surgery. The mean baseline IOP was 24.8 ± 8.4 mmHg across all eyes. IOP decreased to 9.6 ± 4.4 mmHg on postoperative day 1 and remained significantly reduced at 1 year (13.2 ± 3.9 mmHg) and 6 years (13.9 ± 2.3 mmHg). The IOP trajectories were similar in the subgroups. The IOP was slightly lower in eyes that had combined surgery. At 5 years, the complete success was 54%, 36%, and 8% for IOP thresholds of 6-21, 6-18, and 6-14 mmHg, respectively; while the qualified success rates were 62%, 38%, and 15%, respectively. The number of medications decreased significantly after surgery. Early postoperative complications were infrequent and usually transient. The complications were similar across subgroups with choroidal detachment (≤ 12%) and microhyphaema (10-15%) being the most common. Late complications occurred less often, and device-related failure leading to secondary glaucoma surgery rarely occurred (≤ 4%). The MicroShunt provided a sustained reduction in IOP and medication burden with a low incidence of complications over the follow-up period. The outcomes in pseudophakic eyes and those undergoing combined cataract surgery were like the cumulative population. The inclusion of pseudophakic and combined surgery eyes reflects the real-world situation in glaucoma practice. These results build on mid-term evidence to support the reliability and safety of the MicroShunt.

Background: In this study, we aimed to evaluate and compare the diagnostic performance of peripapillary retinal nerve fiber layer (RNFL) thickness, macular ganglion cell-inner plexiform layer (GCIPL) thickness, and GCIPL asymmetry parameters in differentiating healthy eyes from primary angle-closure glaucoma (PACG), primary open-angle glaucoma (POAG), and secondary open-angle glaucoma (SOAG). Methods: This retrospective study included 204 eyes of 204 patients categorized into four groups: healthy controls (n = 46), PACG (n = 53), POAG (n = 58), and SOAG (n = 47). All participants underwent spectral-domain optical coherence tomography (OCT). Peripapillary RNFL thickness, sectoral and average GCIPL thickness, and GCIPL-derived asymmetry ratios were analyzed. Diagnostic performance was assessed using receiver operating characteristic (ROC) analysis. Results: Diagnostic accuracy varied according to glaucoma subtype. In distinguishing POAG from healthy controls, the average RNFL thickness (area under the ROC curve [AUC] = 0.82) demonstrated the highest diagnostic performance, followed by the superotemporal, inferotemporal, and average GCIPL thickness parameters. In contrast, no parameter reached an AUC of ≥0.80 in the PACG or SOAG comparisons. GCIPL asymmetry ratios exhibited limited discriminative ability across most analyses. Subtype differentiation was modest; POAG versus SOAG comparisons yielded AUC values up to 0.66, whereas PACG versus SOAG comparisons demonstrated minimal discrimination (AUC range: 0.47-0.63). Conclusions: Peripapillary RNFL and localized temporal GCIPL thickness measurements provide the highest diagnostic accuracy for identifying POAG. Diagnostic performance is reduced in PACG and SOAG, and the OCT parameters show limited ability to differentiate between glaucoma subtypes. GCIPL asymmetry indices do not enhance diagnostic discrimination beyond direct thickness measurements.

PurposeExfoliation glaucoma (XFG) is the most common secondary glaucoma. Prior studies suggest a higher incidence in women and links to reproductive history, implying estrogen-related pathways. Metabolomic data also indicated inverse associations with steroid-related plasma metabolites, suggesting steroid involvement in XFG pathogenesis.MethodsWe conducted a nested case-control study within the Nurses’ Health Study (NHS) (1980–2018), NHSII (1989–2019), and Health Professionals Follow-up Study (1986–2018), with 217 XFG suspect (XFGS)/XFG cases and 217 matched controls (62 men and 372 women). We evaluated 18 endogenous steroids and five steroid classes using conditional logistic regression. Secondary analyses examined effect modifications by age and residential latitude, and heterogeneity by disease severity (XFGS vs. XFG). Metabolite set enrichment analysis (MSEA) was used for class-level associations. Multiple comparisons were addressed using the number of effective tests (NEF) for individual steroids and false discovery rate (FDR) for steroid classes.ResultsNo individual steroid or steroid class met NEF- or FDR-adjusted significance thresholds, overall or by sex. Nonetheless, across both sexes, MSEA demonstrated a non-significant inverse trend between androgen levels and XFG/XFGS risk (FDR=0.22), with 11-ketotestosterone showing a nominal inverse association (OR=0.54; 95%CI=0.31-0.93; P=0.03). Progestogens showed enrichment scores in the positive trend (FDR=0.31), with a borderline positive association between progesterone and XFG/XFGS (OR=2.21; 95%CI=1.00-4.87; P=0.05).ConclusionsAlthough we observed no statistically significant associations with steroids after correction for multiple testing, the suggestive patterns for androgens and progestogens support the possibility of steroid-related pathways in XFG etiology and support further evaluation in larger studies.

PurposeThis is the first report that describes a case of Kabuki syndrome with peripheral retinal ischemia and neovascular glaucoma.Case reportA 44-year-old woman with genetically confirmed Kabuki syndrome was referred with bilateral elevated intraocular pressure (circa 50mmHG in both eyes), and longstanding poor vision and high myopia (6/60 vision right, counting fingers left eye). Slit-lamp examination revealed bilateral microcornea (10 mm), right eye angle neovascularization, and 3 mm left eye hyphema associated with 360° rubeosis iridis confirmed on fluorescein angiography. Fundoscopy showed a cup-to-disc ratio of 0.5 in right eye and significant peripapillary chorioretinal atrophy, with coloboma-like features in left eye. Widefield fluorescein angiography showed asymmetrical peripheral retinal ischaemia, with telangiectatic mid-peripheral vessels, which leaked in the late phase of fluorescein angiography. A diagnosis of secondary neovascular glaucoma due to ischaemic retinal vasculopathy was made.ConclusionThis case expands the known ocular phenotype of Kabuki syndrome to include peripheral retinal ischaemia and neovascular glaucoma.. It highlights the importance of early, comprehensive ophthalmologic assessment and multidisciplinary management in patients with Kabuki syndrome, especially when complicated by vision-threatening conditions like neovascular glaucoma.

Background/Objectives: Optical coherence tomography-angiography (OCT-A) is a non-invasive method of visualizing the capillary system. As vascular dysregulation impacts glaucoma pathogenesis, the aim of this study was to evaluate APSified-BMO-based-peripapillary vessel density (VD) in patients with ocular hypertension (OHT), pre-perimetric-open-angle glaucoma, as well as primary (POAG) and secondary (SOAG) open-angle glaucoma in comparison to healthy controls using OCT-A. Methods: The present study included 180 eyes from 115 patients of the Erlangen Glaucoma Registry, divided into 35 eyes with OHT, 16 pre-perimetric-OAG eyes, 64 OAG eyes-which were subdivided into 37 POAG and 27 SOAG eyes-and 65 healthy controls. All subjects underwent measurements of the retinal nerve fiber layer (RNFL), inner nuclear layer (INL), retinal ganglion cell (RGC) layer, and Bruch membrane opening-minimum rim width (BMO-MRW). APSified-BMO-based-peripapillary vessel density (VD) was visualized by using OCT-A and quantified using the Erlangen Angio Tool. Results: Mean APSified-BMO-based peripapillary VD showed a significant correlation with age (p < 0.0001). Considering the age effect, mean APSified-BMO-based peripapillary VD of OAG was significantly lower compared to healthy eyes (p < 0.0001) and OHT (p = 0.016). Subgroup analysis yielded a significant difference in mean APSified-BMO-based peripapillary VD between controls and POAG (p = 0.001) and SOAG (p = 0.018), respectively. In addition, a significant difference was observed between OHT and POAG patients (p = 0.036). No significant differences were observed between the OHT, pre-perimetric-OAG, and healthy eyes, respectively. Conclusions: As peripapillary VD was significantly decreased in glaucoma patients compared to controls, the data might suggest that peripapillary VD might be useful for monitoring glaucoma progress.

Comparative efficacy of glaucoma drainage device versus ab-interno trabeculotomy in vitrectomized eyes with secondary glaucoma.

The aim of this study was to evaluate the influence of demographic, clinical and physical factors on the occurrence of ocular complications after ruthenium-106 (Ru-106) brachytherapy, iodine-125 (I-125) brachytherapy and proton therapy of uveal melanoma. A retrospective analysis of 300 patients' electronic and paper medical records treated for uveal melanoma at the Department of Ophthalmology and Ocular Oncology, University Hospital in Krakow, Poland, from May 2014 to December 2016 was performed. The created database, which includes numerous parameters characterizing patients, tumors, applied treatments and their effects, with particular emphasis on the occurrence of ocular complications, was subjected to detailed analysis. The influence of selected factors on the occurrence of identified complications was checked by performing a univariable Cox proportional hazards regression analysis, and then the factors that were statistically significant were included in a multivariable Cox proportional hazards regression analysis which gave the final results. Of the 300 patients, 125 (41.67%) were treated with Ru-106 brachytherapy (87 (29%) with CCB plaque and 38 (12.67%) with COB plaque), 102 (34%) with I-125 brachytherapy and 73 (24.33%) with proton therapy. Mean follow-up was 88.63 months (median 89, range: 20-127). The occurrence of cataract was associated with the older age of patients. Maculopathy was associated with female sex, younger age, use of I-125 brachytherapy, tumor location involving the macula and/or optic disc and moderate tumor pigmentation. Diagnosis of systemic hypertension was associated with a lower risk of maculopathy. Retinopathy was associated with younger age, tumor location involving the macula and/or optic disc and the use of I-125 brachytherapy. Optic neuropathy was associated with younger age, greater tumor largest base diameter, tumor location involving the macula and/or optic disc and the use of I-125 brachytherapy. Secondary glaucoma was associated with baseline best corrected visual acuity (BCVA) weaker than 0.5, greater tumor thickness, involvement of the left eye and the use of I-125 brachytherapy. Vitreous hemorrhage was associated with greater tumor thickness, tumor location including the macula and/or optic disc and mushroom-shaped tumor. Our study demonstrated an association between demographic, clinical, and physical factors and the occurrence of ocular complications after radiotherapy for uveal melanoma.

To evaluate the functional outcomes and complications of pars plana vitrectomy with scleral flaps covered with a two-point sutured scleral-fixated intraocular lens (SFIOL). A retrospective, single-center, single-surgeon case study, including 97 cases. About 25 G pars plana vitrectomy with a two-point sutured scleral-fixated IOL was used as a surgical modality. This study included 97 patients and eyes with scleral IOL fixation, with a mean follow-up of 6 months. The indications for SFIOL were divided into cases of surgical aphakia (63, 64.94%), hyper-mature cataract not suitable for routine procedure (5,5.15%), traumatic cataracts not suitable for routine procedures (18,18.5%), and other categories (11,64.94%). In this study, the median ± standard deviation of best-corrected visual acuity (BCVA) values in logarithm of the minimum angle of resolution (LogMAR) pre, post 1 month, 3 months, 6 months showed statistically significant improvement in VA with P value <0.001. The most common complications as number of cases seen in our study were cystoid macular edema (four cases), Descemet membrane folds (three cases), epiretinal membrane (five cases), exposed suture knots (one case), iatrogenic retinal break (two cases), iatrogenic retinal touch (two cases), IOL edge glare (one case), IOL tilt (one case), secondary glaucoma (three cases), post-op uveitis (one case), retinal detachment (one case), no complications 73 cases out of total cases. The mean BCVA improved from preoperative to postoperative 1 day, 1 month, 3 months, and 6 months (P < 0.001) using this technique. This technique, which is more time-consuming, offers advantages over other available options, including improved stability, reduced risk of complications, and enhanced visual outcome.

PurposeTo evaluate the efficacy and safety of micropulse transscleral cyclophotocoagulation (MP-TSCPC) for refractory glaucoma.Patients and MethodsThis prospective multicenter study included 62 eyes of 57 refractory glaucoma patients. MP-TSCPC was performed from August 2022 to May 2023. All patients had a complete ophthalmic examination preoperatively, including medical history, slit-lamp examination, best-corrected visual acuity (BCVA) assessment, and pre- and post-operative intraocular pressure (IOP) measurements. The main outcomes included IOP change, antiglaucoma medication use, the cumulative incidence of treatment success, and the postoperative complications over 24 months. Treatment success was defined as an IOP reduction of more than 20% compared with baseline or a decrease in the number of antiglaucoma medications with stable target IOP. Retreatments were classified as failures.ResultsThe glaucoma subtypes included primary glaucoma (n=29) and secondary glaucoma (n=33). Prior glaucoma surgery had been performed in 48 of the 62 eyes (77.4%), with 30 of them having multiple types of surgery. Preoperatively, the mean IOP was 38.2±10.3 mmHg and the median number of antiglaucoma medications used was 3.0 (2.0, 3.0); these values decreased to 20.9±8.8 mmHg (a reduction of 42.7%; P<0.001) and 2.0 (0.0, 3.0) (P<0.001) at month 24, respectively. The treatment success rate was 77.4% at 24 months. Postoperative complications included mydriasis (n=10), conjunctival hemorrhage (n=9), mild anterior chamber inflammation (n=1), hyphema (n=1), mild ciliary body detachment (n=3), and choroidal detachment (n=1), all reversible after treatment.ConclusionMP-TSCPC appears to be a safe and effective treatment option for refractory glaucoma.