MicroPulse Transscleral Laser Therapy: A Retrospective Study of Dose Efficacy and Safety.

Aim: To evaluate the efficacy and safety of MicroPulse transscleral laser therapy (MPTLT) for cyclophotocoagulation in the treatment of glaucoma with different doses of energy.

Materials and methods: A retrospective review was done of 136 eyes in 90 patients treated with MPTLT between 2018 and 2022. Intraocular pressures (IOP) at follow-ups were compared with a paired student t-test and treatment outcomes with a Chi-squared test. The cohort was stratified into subgroups to analyze the effect of total applied energy on outcomes. The variance between energy groups was analyzed with the Kruskal-Wallis test adjusted for multiple comparisons.

Results: A total of 136 eyes of 90 patients underwent MPTLT for mostly open angle (36.0%) and childhood glaucoma (30.1%). Applied energy range was between 37.5 and 195.6 J with a mean [standard deviation (SD)] of 100.7 (34.3) J. Applied energy of 125-200 J reduced IOP the most at 2 years with 90% of eyes within 6-21 mm Hg and 66% of eyes having IOP reduced at least 20% (p < 0.001) from baseline. However, at 2 years, energy 50-75 J achieved fewer eyes with two or more Snellen lines lost than energy 125-200 J and a lower proportion of eyes with at least one symptom (p < 0.05). No severe complications of hypotony, phthisis bulbi, or chronic inflammation were reported.

Conclusion: IOP reduction and safety outcome of MPTLT varied with applied energy. Doses should be adjusted to target the treatment goals for individual patients.

Clinical significance: MPTLT was found to be effective in lowering IOP in glaucoma. Using high levels of energy is associated with higher rates of complications.

How to cite this article: Nguyen J, González-Martínez OG, Khouri AS. MicroPulse Transscleral Laser Therapy: A Retrospective Study of Dose Efficacy and Safety. J Curr Glaucoma Pract 2024;18(3):121-129.