Micropulse vs. continuous wave transscleral cyclophotocoagulation in neovascular glaucoma

Zemba,Mihail; Dumitrescu,Otilia-Maria; Vaida,Florin; Dimirache,Elena-Andreea; Pistolea,Iulia; Stamate,Alina Cristina; Burcea,Marian; Branisteanu,Daniel Constantin; Balta,Florian; Barac,Ileana Ramona

doi:10.3892/etm.2022.11207

Micropulse vs. continuous wave transscleral cyclophotocoagulation in neovascular glaucoma

Authors:
- Mihail Zemba
- Otilia-Maria Dumitrescu
- Florin Vaida
- Elena-Andreea Dimirache
- Iulia Pistolea
- Alina Cristina Stamate
- Marian Burcea
- Daniel Constantin Branisteanu
- Florian Balta
- Ileana Ramona Barac
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Affiliations: Department of Ophthalmology, ‘Dr. Carol Davila’ Central Military Emergency University Hospital, 01082 Bucharest, Romania, Division of Biostatistics and Bioinformatics, University of California, San Diego, CA 92093, USA, Department of Ophthalmology, Arena Med Clinic, 022117 Bucharest, Romania, Department of Ophthalmology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania, Department of Ophthalmology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
Published online on: February 11, 2022 https://doi.org/10.3892/etm.2022.11207
Article Number: 278
Copyright: © Zemba et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Neovascular glaucoma (NVG) is a refractory form of glaucoma, associated with important morbidity, for which no consensus exists regarding the optimal choice of therapy. The primary aim of our study was to compare the performances of micropulse transscleral cyclophotocoagulation (MP‑TSCPC) and continuous wave transscleral cyclophotocoagulation (CW‑TSCPC) in the treatment of neovascular glaucoma (NVG). A total of 24 eyes for MP‑TSCPC and 22 eyes for CW‑TSCPC, all with NVG were included. The procedures were performed using either the Iridex Cyclo G6 (IRIDEX Laser System), the MP3, or the G‑Probe devices. Intraocular pressure (IOP), visual acuity (VA), the mean number of antiglaucoma medications, and postoperative complications were monitored. The minimum follow‑up was 12 months. The success rate at 12 months was 54.5% in the CW‑TSCPC group and 33.3% in the MP‑TSCPC group. The mean IOP at baseline was 35.82 mm Hg for CW‑TSCPC and 34.71 mm Hg for MP‑TSCPC. The change from baseline in IOP at 12 months was 11.95 mm Hg in the CW‑TSCPC group and ‑8.04 mm Hg in the MP‑TSCPC group. There was a significant difference in the occurrence of serious complications (worsening of VA, hypotony, and phthisis bulbi) between the two methods, with CW‑TSCPC associated with more important adverse effects (P=0.045). There was a decrease in the number of topical antiglaucoma medications in both groups: in the MP‑TSCPC group from a mean number of 2.6 at baseline, to 1.7 at 3 months, followed by a slight increase to 2.1 at 12 months and in the CW‑TSCPC group from 2.8 at baseline, to 1.4 at 3 months and 1.9 at 12 months. Our study concluded that both MP‑TSCPC and CW‑TSCPC could manage NVG, but, while CW‑TSCPC revealed higher IOP control in the long term (which did not reach statistical significance), it also had a significantly lower safety profile.

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