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Double-Session Micropulse Transscleral Laser (CYCLO G6) as a Primary Surgical Procedure for Glaucoma

DOI:10.1097/IJG.0000000000001426 期刊:Journal of Glaucoma 出版年份:2019 更新时间:2025-09-12 10:27:22
摘要: PURPOSE: To evaluate the safety and effectiveness of double-session micropulse transscleral laser (MP3) as a primary treatment modality for glaucoma. METHODS: Patients who underwent MP3 therapy with double sessions in each hemifield, with a follow-up period of at least 6 months, were retrospectively considered. Patients were categorized into two groups: GI (no previous glaucoma surgery) and GII (with previous glaucoma surgery). Success was defined by either achieving a final intraocular pressure (IOP) between 6 and 18 mmHg and an IOP reduction of more than 20%, or a minimum 50% reduction in the number of glaucoma medications, at the last visit, without any serious complications. RESULTS: Eighty-four eyes were included in the GI group and 101 in the GII group, with the latter demonstrating relatively higher preoperative IOP (31.1±5.4 vs. 26.2±6.9 mmHg, p<0.001). Final IOP (14.9±5.2 vs. 13.6±4.1 mmHg, p=0.06), average MP3 treatment time (358.0±50.7 vs. 362.7±67.8 seconds, p=0.5), and follow-up duration (10.8±5.1 vs. 12.3±5.4 months, p=0.06) were similar between the groups. The percentage reduction with regard to glaucoma medication was higher in GI than in GII (49.1±28.8 vs. 38.8±30.1%, p=0.02). GI underwent fewer MP3 procedures than GII (1.2±0.5 vs. 1.5±0.8, p=0.002). No hypotony or phthisis bulbi was observed in GI (1 and 2 in GII, respectively). Procedural success was noted in 92.9% of the cases in GI and 87.1% in GII. CONCLUSION: Double-session MP3 therapy could be considered as a safe and effective procedure to treat glaucoma in eyes that have not undergone any previous glaucoma surgery. Primary eyes achieved a success-rate similar to those with refractory glaucoma with fewer MP3 procedures and fewer glaucoma medications.
作者: Leopoldo Magacho,Francisco E. Lima,Marcos P. ávila
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To evaluate the safety and effectiveness of double-session micropulse transscleral laser (MP3) as a primary treatment modality for glaucoma.

Double-session MP3 therapy could be considered as a safe and effective procedure to treat glaucoma in eyes that have not undergone any previous glaucoma surgery. Primary eyes achieved a success-rate similar to those with refractory glaucoma with fewer MP3 procedures and fewer glaucoma medications.

The retrospective nature of the study and the absence of a rigid protocol with well-established criteria to determine the time of MP3 application in the double-session technique according to each case are the main limitations of this study. Additionally, it is possible that the milder forms of subclinical mydriasis may have been missed.

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