PURPOSE This study evaluates the 6-month safety and efficacy of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in cases of uncontrolled glaucoma/ocular hypertension using a reduced energy protocol. METHODS Retrospective analysis of patients undergoing MP-TSCPC from January-April 2018 was carried out. Patients received up to 90 s of laser with settings of 2000 mW/Cm2 and a duty cycle of 31.3%. RESULTS A total of 29 patients were included, with a mean age of 64.7 ± 15.1 years. The most common diagnosis was primary open angle glaucoma (41.4%) with a mean Logmar visual acuity of 1.5 ± 1.2. All subjects had either undergone intraocular surgery (58.6% filtration surgery) or continuous wave diode laser prior to micropulse treatment. Mean pre-laser IOP was 26.2 ± 11.1 mmHg. There was a significant reduction (p < 0.05) in IOP at 1 month to 15.8 ± 5.4 mmHg (39.7% reduction), at 3 months to 15.04 ± 5.25 mmHg (42.6% reduction) and at 6 months to 18.19 ± 7.47 mmHg (30.6% reduction). There was also a corresponding reduction (p < 0.05) in the number of topical agents required to control pressure from a baseline of 3.31 ± 0.97, to 2.72 ± 0.88 at 1 month, 2.76 ± 0.91 at 3 months and 2.90 ± 1.08 at 6 months. Requirements for oral acetazolamide reduced from 41.3% (1/29) at baseline to 3.4% (1/29) at 6 months. Success rates were 75.9% at 1 month, 79.3% at 3 months and 58.6% at 6 months. There was no drop in the visual acuity, no change in central retinal thickness and no cases of intraocular inflammation. CONCLUSIONS MP-TSCPC at a decreased duration is effective at reducing intraocular pressure in ethnically diverse glaucoma patients refractory to previous glaucoma laser or surgeries at 6 months follow-up, with no significant complications. Further work is needed to confirm efficacy in the long term and to determine optimal settings.

中文翻译：

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微脉冲巩膜环光凝术：难治性青光眼使用降低能量方案的初步结果。

目的这项研究评估了微脉冲经巩膜环光凝术（MP-TSCPC）在未控制的青光眼/高眼压症患者中使用降低的能量方案的6个月安全性和有效性。方法对2018年1月至4月接受MP-TSCPC的患者进行回顾性分析。患者接受长达90 s的激光，设置为2000 mW / Cm2，占空比为31.3％。结果共纳入29例患者，平均年龄为64.7±15.1岁。最常见的诊断是原发性开角型青光眼（41.4％），平均Logmar视力为1.5±1.2。在微脉冲治疗之前，所有受试者均接受了眼内手术（58.6％滤过手术）或连续波二极管激光。激光前平均眼压为26.2±11.1 mmHg。显着降低（p <0。05）IOP在1个月达到15.8±5.4 mmHg（降低39.7％），3个月达到15.04±5.25 mmHg（降低42.6％），6个月达到18.19±7.47 mmHg（降低30.6％）。控制压力所需的局部用药数量也相应减少（p <0.05），从基线的3.31±0.97降至1个月的2.72±0.88、3个月为2.76±0.91和6个月为2.90±1.08 。口服乙酰唑胺的需求量从基线时的41.3％（1/29）降至6个月时的3.4％（1/29）。1个月的成功率为75.9％，3个月的成功率为79.3％，6个月的成功率为58.6％。视力没有下降，视网膜中央厚度没有变化，也没有眼内炎症的病例。结论减少持续时间的MP-TSCPC可有效降低在过去6个月的随访中对先前青光眼激光或手术难以治疗的种族多样化的青光眼患者的眼内压，无明显并发症。需要进一步的工作以确认长期效果并确定最佳设置。