DOI: 10.1097/ijg.0000000000002752 ISSN: 1057-0829

Comparative Outcomes Between Micropulse and Slow-Coagulation Transscleral Cyclophotocoagulation in Eyes With Good Visual Acuity

Maria Rita R. Chaves, Vital Paulino Costa, Izabela N. F. Almeida, Heloísa A. Maestrini, Leopoldo Magacho, Fábio Nishimura Kanadani, Tiago S. Prata, César Lima Neto, Ricardo Y. Abe

Precis:

Despite both CW TSCPC and MP-TSCPC are effective in reducing IOP, with low rates of complications, MP-TSCPC seems to achieve higher success rates with less significant visual acuity loss compared to CW TSCPC.

Purpose:

To compare the efficacy and safety of continuous wave transscleral cyclophotocoagulation (CW TSCPC) using slow-coagulation technique versus micropulse (MP) TSCPC in patients with glaucoma and good visual acuity.

Patient and Methods:

Retrospective multicenter study including patients with logMAR visual acuity (VA) of <0.5 and at least 6 months of follow-up. Surgical success was defined as IOP ≤ 18 mm Hg and at least 30% reduction from baseline IOP with or without glaucoma medication, without loss of >2 lines of vision. For criterion A, patients that required a new CPC session during follow-up were considered as failure. For criterion B, the additional need for CPC was not considered as failure.

Results:

We included a total of 200 eyes from 200 glaucoma patients (110 eyes in CW TSCPC and 90 in MP-TSCPC groups). There was a significant reduction of IOP levels and number of medications after CPC in both groups ( P <0.001). Considering criterion, A, success rates at 12 months were 61% and 76% in the CW TSCPC and MP-TSCPC groups, respectively ( P =0.087). Considering criterion B, success rates were 75% and 87% in the CW TSCPC and MP-TSCPC groups, respectively ( P =0.289). Significant VA loss was observed in 20% of the eyes in the CW TSCPC group and 10% of the eyes in the MP-TSCPC group ( P =0.016).

Conclusion:

Both CW TSCPC and MP-TSCPC are safe and effective in reducing IOP, with low rates of complications or serious adverse events.

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