Wesam S Shalaby, Amirmohsen Arbabi, Jae-Chiang Wong, Aakriti G Shukla, Reza Razeghinejad, Daniel Lee, Marlene R Moster, Jonathan S Myers, Natasha N Kolomeyer
{"title":"Early Postoperative Intraocular Pressure Profile Following Micropulse vs Continuous Wave Transscleral Cyclophotocoagulation: Cohort Study.","authors":"Wesam S Shalaby, Amirmohsen Arbabi, Jae-Chiang Wong, Aakriti G Shukla, Reza Razeghinejad, Daniel Lee, Marlene R Moster, Jonathan S Myers, Natasha N Kolomeyer","doi":"10.5005/jp-journals-10078-1466","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To compare the risk of early intraocular pressure (IOP) spikes following micropulse (MP) vs continuous wave (CW) transscleral cyclophotocoagulation (CPC).</p><p><strong>Methods: </strong>Single-center, prospective, nonrandomized study that included glaucoma patients planned for MP- or CW-CPC at Wills Eye Hospital (2020-2021). IOP was measured using rebound tonometry (iCare) immediately before, immediately after, and 1 hour after the CPC, then on postoperative day 1. The primary outcome measure was the incidence of IOP spikes, defined as IOP elevation ≥10 mm Hg vs baseline. Patients with severe IOP spikes received IOP-lowering agents (topical or oral).</p><p><strong>Results: </strong>Twenty-six eyes (15 CW and 11 MP) of 26 patients were included, with a mean age of 64.4 ± 15.1 years. At the baseline visit, IOP was 29.5 ± 11.3 mm Hg, and the medication number was 3.8 ± 1.4, with no difference between groups. IOPs (CW vs MP, mm Hg) were 31.9 ± 10.5 vs 24.1 ± 7.3 immediately before CPC (<i>p</i> = 0.044), 22.9 ± 10.8 vs 16.1 ± 6.3 immediately after CPC (<i>p</i> = 0.760), 24.6 ± 11.9 vs 23.2 ± 9.5 at 1 hour after CPC (<i>p</i> = 0.757), and 18.0 ± 6.1 vs 20.8 ± 6.9 at 1 day later (<i>p</i> = 0.335). Three eyes (11.5%; 1 CW, 2 MP) experienced IOP spikes (<i>p</i> = 0.556) at 1 hour post-CPC; IOP responded to topical and/or oral medications. At day 1 and month 1, mean IOP reduction compared to baseline was significant in CW eyes (<i>p</i> < 0.001) and insignificant in MP eyes (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>MP- and CW-CPC have similar risks of early postoperative IOP spikes. Significant early IOP reduction was better achieved following CW-CPC. Early postoperative IOP spikes may be detrimental; there may be a role for IOP monitoring in such cases.</p><p><strong>Clinical significance: </strong>Understanding the early postoperative outcomes of MP- and CW-CPC is critical for optimizing glaucoma management. This study highlights that while both procedures carry a similar risk of early IOP spikes, CW-CPC demonstrates superior early IOP reduction. These insights help clinicians tailor CPC strategies to individual patient requirements.</p><p><strong>How to cite this article: </strong>Shalaby WS, Arbabi A, Wong J, <i>et al</i>. Early Postoperative Intraocular Pressure Profile Following Micropulse vs Continuous Wave Transscleral Cyclophotocoagulation: Cohort Study. J Curr Glaucoma Pract 2025;19(1):8-14.</p>","PeriodicalId":15419,"journal":{"name":"Journal of Current Glaucoma Practice","volume":"19 1","pages":"8-14"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096860/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Current Glaucoma Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5005/jp-journals-10078-1466","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/24 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Aim: To compare the risk of early intraocular pressure (IOP) spikes following micropulse (MP) vs continuous wave (CW) transscleral cyclophotocoagulation (CPC).
Methods: Single-center, prospective, nonrandomized study that included glaucoma patients planned for MP- or CW-CPC at Wills Eye Hospital (2020-2021). IOP was measured using rebound tonometry (iCare) immediately before, immediately after, and 1 hour after the CPC, then on postoperative day 1. The primary outcome measure was the incidence of IOP spikes, defined as IOP elevation ≥10 mm Hg vs baseline. Patients with severe IOP spikes received IOP-lowering agents (topical or oral).
Results: Twenty-six eyes (15 CW and 11 MP) of 26 patients were included, with a mean age of 64.4 ± 15.1 years. At the baseline visit, IOP was 29.5 ± 11.3 mm Hg, and the medication number was 3.8 ± 1.4, with no difference between groups. IOPs (CW vs MP, mm Hg) were 31.9 ± 10.5 vs 24.1 ± 7.3 immediately before CPC (p = 0.044), 22.9 ± 10.8 vs 16.1 ± 6.3 immediately after CPC (p = 0.760), 24.6 ± 11.9 vs 23.2 ± 9.5 at 1 hour after CPC (p = 0.757), and 18.0 ± 6.1 vs 20.8 ± 6.9 at 1 day later (p = 0.335). Three eyes (11.5%; 1 CW, 2 MP) experienced IOP spikes (p = 0.556) at 1 hour post-CPC; IOP responded to topical and/or oral medications. At day 1 and month 1, mean IOP reduction compared to baseline was significant in CW eyes (p < 0.001) and insignificant in MP eyes (p > 0.05).
Conclusion: MP- and CW-CPC have similar risks of early postoperative IOP spikes. Significant early IOP reduction was better achieved following CW-CPC. Early postoperative IOP spikes may be detrimental; there may be a role for IOP monitoring in such cases.
Clinical significance: Understanding the early postoperative outcomes of MP- and CW-CPC is critical for optimizing glaucoma management. This study highlights that while both procedures carry a similar risk of early IOP spikes, CW-CPC demonstrates superior early IOP reduction. These insights help clinicians tailor CPC strategies to individual patient requirements.
How to cite this article: Shalaby WS, Arbabi A, Wong J, et al. Early Postoperative Intraocular Pressure Profile Following Micropulse vs Continuous Wave Transscleral Cyclophotocoagulation: Cohort Study. J Curr Glaucoma Pract 2025;19(1):8-14.
目的：比较微脉冲（MP）与连续波（CW）经巩膜循环光凝（CPC）术后早期眼压（IOP）尖峰的风险。方法：单中心、前瞻性、非随机研究，纳入计划在威尔斯眼科医院（Wills Eye Hospital）接受MP-或CW-CPC治疗的青光眼患者（2020-2021）。术前、术后、术后1小时分别用iCare测眼压。主要结局指标是IOP尖峰的发生率，定义为IOP与基线相比升高≥10mmhg。严重IOP尖峰的患者接受降低IOP的药物治疗（局部或口服）。结果：纳入26例患者26只眼（15只CW眼，11只MP眼），平均年龄64.4±15.1岁。基线就诊时，IOP为29.5±11.3 mm Hg，用药次数为3.8±1.4次，组间差异无统计学意义。CPC前IOPs （CW vs MP, mm Hg）为31.9±10.5 vs 24.1±7.3 (p = 0.044)， CPC后立即为22.9±10.8 vs 16.1±6.3 (p = 0.760)， CPC后1小时为24.6±11.9 vs 23.2±9.5 (p = 0.757)， 1天后为18.0±6.1 vs 20.8±6.9 （p = 0.335）。三只眼睛(11.5%；1名CW， 2名MP)在cpc后1小时出现IOP峰值（p = 0.556）；眼压对局部和/或口服药物有反应。在第1天和第1个月，与基线相比，CW眼的平均IOP降低显著（p < 0.001），而MP眼不显著（p < 0.05）。结论：MP-和CW-CPC术后早期IOP尖峰风险相似。CW-CPC术后早期眼压明显降低效果更好。术后早期IOP尖峰可能有害；在这种情况下，可能需要进行眼压监测。临床意义：了解MP-和CW-CPC术后早期预后对优化青光眼治疗至关重要。该研究强调，虽然这两种手术都有类似的早期IOP尖峰风险，但CW-CPC在早期IOP降低方面表现出色。这些见解有助于临床医生定制CPC策略，以满足个别患者的需求。本文来源：Shalaby WS， Arbabi A, Wong J，等。微脉冲与连续波经巩膜光凝术后早期眼压分布：队列研究。中华青光眼杂志，2015;19(1):8-14。
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
