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Abstract

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.

Purpose: The aim of this study was to investigate the treatment outcome of MPCPC as an adjunctive treatment for refractory glaucoma.

Study design: Retrospective interventional case series.

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 < 21 mmHg or IOP reduction of 20% from baseline IOP.

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).

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.