Posters

Comparing the efficacy and safety of MicroPulse transscleral cyclophotocoagulation (MP-TSCPC) and continuous wave transscleral cyclophotocoagulation (CW-TSCPC)

Poster Details

First Author: M.Chachanidze USA

Co Author(s):    E. Klug   D. Solá-Del Valle                 

Abstract Details

Purpose:

Transscleral cyclophotocoagulation is an effective glaucoma procedure that has been historically used as a treatment of last resort due to high complication rates.In recent years, MP-TSCPC has emerged as a potentially favorable alternative to traditional CW-TSCPC. However, there is a lack of consensus both clinically and in the literature as to whether MP-TSCPC actually provides any safety benefits. Therefore, the purpose of this retrospective study was to compare the safety and effectiveness of MP-TSCPC to that of CW-TSCPC using the IRIDEX’s Generation-1 (G1) MP3 probe and G-probe devices (IRIDEX, Mountain View, CA), respectively

Setting:

This was a retrospective, non-randomized case-controlled study was performed between January 2018 and November 2019. in the glaucoma department at Massachusetts Eye and Ear, Harvard Medical School, Boston, USA.

Methods:

Data were collected from one provider who performed CW-TSCPC, and another who performed MP-TSCPC. Patients were matched by glaucoma type and stage, age, race, and sex. Data was collected from the most recent preoperative visit, and follow-up evaluations approximately 1 day, 1 month, 3 months, 6 months, and 1 year postoperatively. Data collected included patient demographics, diagnosis, cup-to-disk ratios, intraocular pressure (IOP), visual acuity (VA), number of glaucoma medications, and postoperative complications. T-tests were used to compare changes in IOP, medications, and VA. Chi-squared tests were used to compare baseline characteristics and incidences of postoperative complications.

Results:

34 eyes (17 per group) were included. Baseline IOP was 25.9 mmHg in the CW-TSCPC group and 25.3 mmHg in the MP-TSCPC group (p=0.86). On postoperative day 1 (POD1), the MP-TSCPC group experienced a greater mean reduction in IOP (13.7 mmHg vs 6.8 mmHg; p=0.05). This was the only significant group difference in IOP reduction. A greater proportion of MP-TSCPC patients achieved a ≥20% reduction in IOP at all timepoints, however these differences were not significant (Table 2). There were no differences in other rates of inflammation, cystoid macular edema, or hypotony.

Conclusions:

This retrospective study highlights the efficacy and safety of both CW-TSCPC and MP-TSCPC. Both procedures effectively lowered IOP and reduced patients’ medication burden with few complications, and no sight-threatening complications. The current study may provide evidence that there are no clinically significant differences in the rates of complications between the two laser delivery systems, or their ability to lower IOP. However, these results suggest that MP-TSCPC may be more effective in lowering medication burden in the long term, and results in less inflammation on postoperative day one.

Financial Disclosure:

None