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  • Evaluation of Micropulse Cyclophotocoagulation

    By Jean Shaw
    Selected By: Henry D. Jampel, MD, MHS

    Journal Highlights

    Ophthalmology Glaucoma, May/June 2020

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    Kaba et al. set out to evaluate whether micropulse cyclophotocoagulation (MP-CPC) is a safe and effective treatment for treating ocular hypertension (OHT) and glaucoma. They found that it is, with patients experiencing a mean reduction in intraocular pressure (IOP) of 20% or more over baseline at the one-year mark. However, they also found that patients in certain subgroups—notably those with normal-tension glaucoma or a baseline IOP of ≤21 mm Hg—had a more limited response.

    The researchers assessed the results of 399 MP-CPC surgeries (399 eyes of 214 patients) performed between May 2016 and May 2018 in Canada. The main outcome measure was IOP; secondary outcomes included use of glaucoma medications and ocular adverse effects.

    Patients were evaluated at four points postoperatively. At baseline, mean IOP was 19.8 ± 7.4 mm Hg; reductions in IOP were 22.7%, 20.2%, 20.7%, and 23.7% at the one-, three-, six-, and 12-month evaluations, respectively (p < .0001 for all timepoints). All told, 68% of the study eyes achieved a ≥20% mean reduction in IOP from baseline. However, the mean IOP reduction in eyes with normal-tension glaucoma was 7.6% from baseline. In addition, a subanalysis based on IOP stratification found that mean IOP reduction was 32% at post-op month 1 for those eyes with a baseline IOP of >21 mm Hg, versus 17.1% for those with a baseline IOP ≤21 mm Hg.

    With regard to secondary outcomes, more than two-thirds of the eyes were being treated with topical glaucoma medications preoperatively. This stayed roughly the same throughout the study. However, of the 25 patients initially on oral glaucoma medications, 18 (72%) were able to discontinue their use by the 12-month mark. The most com­mon adverse events were vision loss, IOP spike, and cataract. Eight patients needed a minimally invasive glaucoma surgery procedure during the study.

    The original article can be found here.