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  • Micropulse cyclophotocoagulation may lead to complications in glaucoma patients

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    Review of: Micropulse Cyclophotocoagulation: A Multicenter Study of Efficacy, Safety, and Factors Associated With Increased Risk of Complications

    Radhakrishnan S, Wan J, Tran B, et al. Journal of Glaucoma, December 2020

    Investigators assessed the efficacy and complications of micropulse cyclophotocoagulation (MPCP) for glaucoma.

    Study design

    This was a multicenter, retrospective chart review of 143 patients (167 eyes) with various types and stages of glaucoma. Many patients had good visual acuity and no history of glaucoma surgery. Mean follow-up was approximately 1 year.

    Outcomes

    By the last follow-up visit, the success rate of MPCP was 36.5% (61/167 eyes). Twenty-four patients (15%) lost 3 or more Snellen lines of visual acuity (VA). The most common complication was mydriasis (11%), followed by persistent punctate keratitis; 73% of patients did not experience complications. Asian race and phakia were associated with higher odds of developing mydriasis (OR 13.5 and 3.1, respectively).

    Limitations

    This was a retrospective study that lacked a comparison group. This study used the first-generation MP3 handpiece, not the most recent Rev2 handpiece that was released in early 2020.

    Clinical significance

    While MPCP was initially introduced as an addition to the minimally invasive glaucoma surgery (MIGS) toolbox for patients with mild glaucoma and good visual acuity, this study provides more real-world data that suggest it may not provide a favorable safety and efficacy profile for typical MIGS patients.