Efficacy and safety of micropulse cyclophotocoagulation for patients with ocular hypertension and glaucoma

Session Details

Session Title: Presented Poster Session: Glaucoma I

Venue: Poster Village: Pod 3

First Author: : Q.Kaba UK

Co Author(s): :    E. Tam   S. Somani   D. Yuen                 

Abstract Details

Purpose:

To evaluate the efficacy and safety of MP-CPC in patients with ocular hypertension (OHT) and glaucoma (any stage or type including normal tension glaucoma and well-sighted eyes).

Setting:

Retrospective cohort study. Uptown Eye Specialists, Toronto.

Methods:

Consecutive eyes with glaucoma or OHT that underwent MP-CPC (Iridex Cyclo G6 Glaucoma Laser System) between June 2016 and June 2018 were identified. 399 MP-CPC surgeries, on 342 eyes of 214 patients, were analysed. Laser power ranged from 1800-3000mW. Primary outcome measure was intraocular pressure (IOP). Secondary outcome measures included glaucoma medication, visual acuity (VA) and adverse events. Time points included post-operative months (POM) 1, 3, 6 and 12.

Results:

Overall mean baseline IOP was 19.8 ±7.4mmHg and IOP reduction was 19.2% at POM12 (P<0.0001). ≥20% IOP reduction from baseline was achieved by 61% at POM12. The NTG sub-group demonstrated IOP reduction of 7.6% at POM1. IOP reduction was 29.5% when baseline IOP >21mmHg, and 11.5% when £21 (71% overall cohort). Mean IOP reduction was 28.9% with power ≥2500mW and 14.3% with <2500mW.  Each repeat MP-CPC lowered IOP 12.6% (P<0.005).  87% of patients on oral glaucoma medications ceased post-operatively. At POM1 16% experienced visual change. There were no cases of persistent inflammation, hypotony, phthisis bulbi, or sympathetic ophthalmia.

Conclusions:

To our knowledge, this is the largest retrospective MP-CPC cohort to date, and the only study to include OHT, NTG and well-sighted eyes. MP-CPC showed efficacy in lowering IOP sustained out to one year. However, NTG and baseline IOP £21mmHg subgroups showed a more limited response.  Furthermore, there is suggestion of a dose response relationship with respect to laser power and repeat treatments.

Financial Disclosure:

None