Efficacy and safety of micropulse transscleral cyclophotocoagulation in glaucoma: a two-year retrospective audit cohort.

PURPOSE: To retrospectively evaluate the efficacy and safety of Micropulse Transscleral Cyclophotocoagulation (MP-TSCPC) in reducing intraocular pressure (IOP) and the number of glaucoma medications in patients with different types of glaucoma over a two-year period.

METHODS

This retrospective audit included 52 eyes from 32 patients treated with MP-TSCPC at Mountainhall Treatment Centre, Dumfries, UK, between August 2021 and September 2023. Standard treatment parameters included 2500 mW power applied for 10 s per quadrant across 9 cycles. Primary outcomes were changes in IOP and the number of glaucoma medications. Secondary outcomes included postoperative complications and changes in the mean deviation of the visual field (MD).

RESULTS

The mean preoperative IOP was 21.4 mmHg, which significantly decreased postoperatively to 11.9 mmHg at 4 weeks, 12.75 mmHg at 3 months, 13.4 mmHg at 1 year, and 14.03 mmHg at 2 years. The median IOP reduction at 1 year was 5.0 mmHg with statistical significance (p < 0.0001). The average number of topical medications declined from 2.21 eye drops to 1.58 eye drops. No statistically significant change was observed in visual field MD (p = 0.4838), though disease progression appeared to stabilize (mean MD: -7.1 dB). Complications were infrequent and included mild anterior uveitis (n = 12), cystoid macular edema, recurrence of herpetic keratitis and severe ocular inflammation (n = 1).

CONCLUSION

MP-TSCPC is a safe and effective procedure for medium-term IOP control, particularly in patients with primary open-angle glaucoma. It significantly reduces IOP and medication dependency, with a low complication profile. However, outcomes are more variable in secondary glaucoma, especially uveitic cases. These findings support the growing role of MP-TSCPC as a minimally invasive treatment option for glaucoma.