Oya Tekeli1,2, Helin Ceren Köse3,4. 1. Department of Ophthalmology, Faculty of Medicine, Ankara University, Mamak Street, Ankara, 06620, Turkey. oyatekeli@gmail.com. 2. Ankara Üniversitesi Tıp Fakültesi Göz Hastalıkları Anabilim Dalı, Vehbi Koç Göz Hastanesi, Balkiraz Mahallesi, Mamak Cd. 6 A, Mamak/Ankara, 06620, Turkey. oyatekeli@gmail.com. 3. Department of Ophthalmology, Faculty of Medicine, Ankara University, Mamak Street, Ankara, 06620, Turkey. 4. Ankara Üniversitesi Tıp Fakültesi Göz Hastalıkları Anabilim Dalı, Vehbi Koç Göz Hastanesi, Balkiraz Mahallesi, Mamak Cd. 6 A, Mamak/Ankara, 06620, Turkey.
Abstract
PURPOSE: To compare the success rates and safety of micropulse transscleral laser cyclophotocoagulation (MP-TSCPC) for the treatment of refractory glaucoma using the 240-s and 160-s duration protocols in eyes with good visual acuity. METHODS: A retrospective analysis of patients with refractory glaucoma who underwent MP-TSCPC from December 2017 to September 2019 with baseline best-corrected visual acuity (BCVA) of ≥ 20/60. Laser treatments for the moderate and short duration protocols were defined as 240 s and 160 s with settings of 2000 mW/Cm2 and a duty cycle of 31.3%. Follow-up examinations were performed regularly until 12 months after the procedure. RESULTS: Seventy-six eyes of 76 patients were included with BCVA ranging from 20/60 to 20/20. Forty-four eyes were treated with 240 s and 32 eyes were treated with 160-s duration protocols. There was no significant reduction in mean logMAR BCVA and visual field parameters from baseline at any follow-up point in both groups. Visual acuity remained unchanged or improved in 39 of 44 patients (88.6%) in 240-s group and in 28 of 32 patients (87.5%) in 160-s group. Seven of 44 eyes (15.9%) in 240-s group and 12 of 32 eyes (37.5%) in 160-s group required re-treatment for adequate IOP control. After the re-treatments, both protocols showed similar success rates of 79.5% in 240-s group and 75% in 160-s group at 12 months, respectively (p > 0.05). CONCLUSIONS: MP-TSCPC can be offered as a primary surgical treatment for the management of refractory glaucoma in patients with good visual acuity. Considering the high re-treatment rates in 160-s group, the 240-s duration protocol appears to be more effective than 160-s protocol for adequate IOP control.
PURPOSE: To compare the success rates and safety of micropulse transscleral laser cyclophotocoagulation (MP-TSCPC) for the treatment of refractory glaucoma using the 240-s and 160-s duration protocols in eyes with good visual acuity. METHODS: A retrospective analysis of patients with refractory glaucoma who underwent MP-TSCPC from December 2017 to September 2019 with baseline best-corrected visual acuity (BCVA) of ≥ 20/60. Laser treatments for the moderate and short duration protocols were defined as 240 s and 160 s with settings of 2000 mW/Cm2 and a duty cycle of 31.3%. Follow-up examinations were performed regularly until 12 months after the procedure. RESULTS: Seventy-six eyes of 76 patients were included with BCVA ranging from 20/60 to 20/20. Forty-four eyes were treated with 240 s and 32 eyes were treated with 160-s duration protocols. There was no significant reduction in mean logMAR BCVA and visual field parameters from baseline at any follow-up point in both groups. Visual acuity remained unchanged or improved in 39 of 44 patients (88.6%) in 240-s group and in 28 of 32 patients (87.5%) in 160-s group. Seven of 44 eyes (15.9%) in 240-s group and 12 of 32 eyes (37.5%) in 160-s group required re-treatment for adequate IOP control. After the re-treatments, both protocols showed similar success rates of 79.5% in 240-s group and 75% in 160-s group at 12 months, respectively (p > 0.05). CONCLUSIONS: MP-TSCPC can be offered as a primary surgical treatment for the management of refractory glaucoma in patients with good visual acuity. Considering the high re-treatment rates in 160-s group, the 240-s duration protocol appears to be more effective than 160-s protocol for adequate IOP control.
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