Chloé Chamard1, Alex Bachouchi, Vincent Daien, Max Villain. 1. Department of Ophthalmology, Gui de Chauliac Hospital, Montpellier, F-34000 France Univ. Montpellier, Inserm, Neuropsychiatry: epidemiological and clinical research, PSNREC, Montpellier, France The Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, NSW.
Abstract
PRCIS: MP-TSCPC in a 120-s setting reduces IOP with a 6-month success of 45.5%. Only late (>6▒mo) failure seem to present a benefit for retreatment. PURPOSE: To assess micropulse transscleral cyclophotocoagulation (MP-TSCPC) efficacy, safety, factors of success and re-treatment benefit in open angle glaucoma (OAG). PATIENTS AND METHODS: A retrospective consecutive case-series study. We included patients with OAG who were naive of a cycloablative procedure and underwent MP-TSCPC at 2000▒mW for 120 s between May 1, 2017 and October 31, 2019. Success was defined as intraocular pressure (IOP) >5 and ≤21▒mmHg with IOP reduction ≥20% from baseline, without any re-treatment and visual acuity better than negative light perception. MP-TSCPC re-treatment was early and late, before and after 6 months postoperatively, respectively. RESULTS: We included 94 eyes in 94 patients (mean [SD] age 67.2 [13.4] years; 47.9% women). The mean preoperative IOP was 24.9 [7.1] mmHg and was reduced to 18.9 [6.3] at month 6 (P<0.0001). The success rate decreased progressively over time and reached 45.5% at 6 months. Patients with 6-month surgical success had lower mean axial length than others (24.1 [1.5] vs 25.5 [2.1] mm, P=0.05). In patients with early and late MP-TSCPC re-treatment, the 6-month success rate was 16.7% and 63.6%, respectively. CONCLUSION: MP-TSCPC performed in a 120-s setting reduced IOP, with 45.5% success at month 6 and few complications. Axial length was newly described as affecting success, probably linked to ciliary-body position. A re-treatment seemed to be of little benefit in non-responders or those with early failure. Further studies on laser settings and ciliary-body location are required to find the best risk-benefit protocol.
PRCIS: MP-TSCPC in a 120-s setting reduces IOP with a 6-month success of 45.5%. Only late (>6▒mo) failure seem to present a benefit for retreatment. PURPOSE: To assess micropulse transscleral cyclophotocoagulation (MP-TSCPC) efficacy, safety, factors of success and re-treatment benefit in open angle glaucoma (OAG). PATIENTS AND METHODS: A retrospective consecutive case-series study. We included patients with OAG who were naive of a cycloablative procedure and underwent MP-TSCPC at 2000▒mW for 120 s between May 1, 2017 and October 31, 2019. Success was defined as intraocular pressure (IOP) >5 and ≤21▒mmHg with IOP reduction ≥20% from baseline, without any re-treatment and visual acuity better than negative light perception. MP-TSCPC re-treatment was early and late, before and after 6 months postoperatively, respectively. RESULTS: We included 94 eyes in 94 patients (mean [SD] age 67.2 [13.4] years; 47.9% women). The mean preoperative IOP was 24.9 [7.1] mmHg and was reduced to 18.9 [6.3] at month 6 (P<0.0001). The success rate decreased progressively over time and reached 45.5% at 6 months. Patients with 6-month surgical success had lower mean axial length than others (24.1 [1.5] vs 25.5 [2.1] mm, P=0.05). In patients with early and late MP-TSCPC re-treatment, the 6-month success rate was 16.7% and 63.6%, respectively. CONCLUSION:MP-TSCPC performed in a 120-s setting reduced IOP, with 45.5% success at month 6 and few complications. Axial length was newly described as affecting success, probably linked to ciliary-body position. A re-treatment seemed to be of little benefit in non-responders or those with early failure. Further studies on laser settings and ciliary-body location are required to find the best risk-benefit protocol.