Comparison of outcomes of continuous-wave and micropulse trans-scleral cyclophotocoagulation: A retrospective cohort study.

Abstract

PurposeThis study aimed to compare and provide data on the outcomes of continuous wave (CWCPC) and micropulse transscleral cyclophotocoagulation (MPCPC).MethodsThis was a retrospective cohort study of 130 glaucomatous eyes that underwent CWCPC with a minimum 6-month follow-up matched 1:1 with 130 eyes that underwent MPCPC. The main outcome measure was CPC failure, defined as intraocular pressure (IOP) reduction of <20%, therapy advancement, or progression to no light perception. The secondary outcome measure was safety profile and complications.ResultsThe mean age of patients in the CWCPC and MPCPC groups was 64.4 ± 16.4 and 64.0 ± 17.2 years, respectively. Most patients were male (56.5%), and 48.5% were White. Primary open-angle glaucoma was the most common glaucoma diagnosis (40.4%), 58.5% of the patients had severe glaucoma. Mean preoperative IOP and number of medications were 29.8 ± 10.6 mmHg and 3.7 ± 1.3, respectively. The failure rates at 6 months (46.9% vs. 18.5%) and 1 year (61.5% vs. 40.8%) were higher in MPCPC group (p = 0.001). Mean IOP reduction was slightly greater in the CWCPC group (15.1 ± 13.9 mmHg vs. 14.2 ± 10.4, p = 0.5). Lower laser energy (HR:0.995) and MPCPC (HR:1.698) were associated with higher risk of failure (p = 0.002). The complication rate was higher in the CWCPC group (13.8% vs. 4.6%, p < 0.001); vision loss occurred more in the CWCPC group (4.6% vs. 2.3%), and the only phthisis bulbi occurred in one of the eyes of CWCPC group.ConclusionCWCPC was more effective in lowering the IOP despite delivering less total energy than MPCPC but had a higher rate of complications.