LAUSR

© BMJ Publishing Group Limited 2023. No commercial reuse. See rights and permissions. Published by BMJ. DESCRIPTION Micropulse transscleral laser therapy (MPTLT) is a new laser treatment modality for lowering intraocular pressure (IOP) in eyes with refractory glaucoma. The laser uses micropulse instead of continuous wave energy to reduce side effects caused by thermal energy. The technique has gained popularity as a noninvasive mode of glaucoma therapy especially during the COVID19 pandemic with no major side effects being reported unlike continuous wave diode laser cyclophotocoagulation. We recently performed MPTLT with a newgeneration MP3 fibre optic probe (Iridex Cyclo G6) (figure 1A) and came across a unique complication, which has important implications for the ophthalmic surgeon community. A patient in his early 70s presented with primary angle closure glaucoma to our glaucoma clinic with IOP of 26 mm Hg on four antiglaucoma medications in his right eye with vertical cup disc ratio of 0.9. The patient had a previous failed trabeculectomy and undergone cataract surgery 6 months back. It was decided to perform MPTLT to lower the IOP as the patient was not willing to undergo another invasive surgery. We obtained written informed consent for MPTLT and its related complications before surgery. After topical anaesthesia with 0.5% proparacaine, with the laser settings of, power 2500 mW, total duration 80 s, treat mode ON, we performed MPTLT in an appropriate technique instruction according to the device company with the speed of 20 s per hemisphere per pass (surgical video 1).