Wills Eye Conference
Wills Eye Conference
March 13, 2017
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Micropulse transscleral cyclophotocoagulation effective in IOP reduction

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PHILADELPHIA — Micropulse transscleral cyclophotocoagulation was shown to be effective in reducing IOP in advanced glaucoma patients, according to a speaker here.

A retrospective chart review of 79 patients showed a reduction in IOP of at least 20% in 78% of cases, with a mean IOP reduction from 31 mm Hg to 17.3 mm Hg, Alice Williams, MD, said at the Wills Eye Conference.

Alice William

Alice William

Micropulse transscleral cyclophotocoagulation, an alternative to traditional transscleral cyclophotocoagulation, administers a series of laser-delivered pulses followed by a rest period.

“This theoretically allows time for the adjacent tissues to cool and to minimize collateral damage and the complications that are associated with traditional CPC,” Williams said.

Wills Eye Institute is one of the first institutions to use the technology, and the review looked at one surgeon’s experience with it.

In the first 3 months after treatment, patients saw an 80% success rate, which decreased to 78% at final follow-up visits, typically 7.5 months after treatment.

In addition to a mean reduction in IOP of 15 mm Hg, most patients also experienced a reduction in medications, Williams said. However, there were some notable complications observed.

About a quarter of patients experienced inflammation lasting more than 3 months, and four patients had hypotony lasting more than a month, she said.

In addition, 13 patients (16%) experienced the loss of two or more lines of visual acuity, and two patients developed phthisis.

“This is one of the most feared complications of traditional CPC, and while this is thought to be safer, it is still not impossible to have it with this technology,” Williams said.

It is important to note, Williams added, that these complications were observed in advanced glaucoma patients with unhealthy eyes and that further study, including a direct comparison to traditional cyclophotocoagulation, is needed for more detailed analysis.

“People in general had a good response, and it did help people get off some medications as well,” Williams said. “It’s a noninvasive treatment, but not without complications to keep in mind.” – by Rebecca L. Forand

Reference:

Williams A. Micropulse transscleral cyclophotocoagulation in advanced glaucoma Presented at: Wills Eye Conference; March 9-11, 2017; Philadelphia.

Disclosure: Williams reports no relevant financial disclosures.