LAUSR

PRECIS Micropulse trans-scleral cyclophotocoagulation is only moderately effective in lowering intraocular pressure and useful as an adjunct procedure to other glaucoma surgeries. There was a small risk of loss of vision, prolonged hypotony and phthisis bulbi. AIMS To determine the efficacy and safety of a single micropulse trans-scleral cyclophotocoagulation (MPTCP) treatment for an Asian population with advanced glaucoma. METHODS This is a retrospective single-center study of 207 eyes (207 patients) with advanced glaucoma which underwent first-time MPTCP between 1 January 2008 and 31 March 2018. Success was defined as IOP of 6-21▒mmHg or ≥20% reduction in intraocular pressure (IOP) without an increase in glaucoma medication from baseline, and without glaucoma re-operation. The IOP, best-corrected visual acuity (BCVA) and number of glaucoma medications were also analyzed. RESULTS The mean age was 64.9±16.9 (standard deviation) years. The mean follow-up duration was 18.7±16.2 months. The rate of success at post-operative years 1 and 2 follow-up was 44.1% and 32.6%, respectively. The median survival time of MPTCP was 9.0 months and 85 (40.9%) eyes received re-operation. The mean IOP decreased from 31.5±12.0▒mmHg pre-operatively to 22.1±10.3 and 23.8±11.8 at post-operative years 1 and 2, respectively (P<0.0001). The mean number of glaucoma medications was reduced from 3.3±1.0 pre-operatively to 2.6±1.1 and 2.4±1.1 at post-operative years 1 and 2, respectively (P<0.0001). The significant complications included prolonged hypotony (1 eye [0.5%]), phthisis bulbi (7 eyes [3.4%]) and BCVA reduction (29 eyes [13.9%]). CONCLUSION Single first-time MPTCP for advanced glaucoma eyes was moderately effective in lowering IOP but >50% failed by one year.