Micropulse cyclophotocoagulation treats glaucoma by using short laser bursts to target specific biological structures—primarily, the ciliary body epithelium and stroma—to reduce aqueous secretion and, thus, intraocular pressure (IOP).1 These short bursts minimize damage by allowing the tissue to cool down between bursts. Although cyclophotcoagulation techniques date back to the 1930s, it’s only now that researchers are coming to understand that this updated version of the procedure can be used earlier in glaucoma management. In fact, a new report in the Journal of Glaucoma concludes that it could be a suitable first-line intervention. In some cases, it may even operate as an alternative to incisional glaucoma surgeries.1,2
To reach this conclusion, researchers performed a retrospective review of 61 eyes of 46 patients.2 The participants all had a best-corrected visual acuity better than or equal to 20/60 and had undergone the procedure at the Mayo Clinic and Ross Eye Institute between July 2016 to August 2017.2 They found that the patients’ mean IOP and mean number of glaucoma meds used were both significantly reduced from baseline at various follow-up visits.2 A year on, mean IOP was reduced 40.2% from baseline with 85.4% of patients seeing an IOP drop 20% or more. Mean glaucoma medications used sunk from by 0.82±0.53, with 79.6% patients seeing a reduction of one or more medications.2 The probability of at least a 20% IOP reduction was 74.14%. Also, 75% of patients were deemed to need no further glaucoma surgeries at the one-year follow up.2
1. Eliassi-Ra B. Cyclodestructive procedures in treatment of glaucoma. Eyewiki. eyewiki.aao.org/Cyclodestructive_Procedures_in_Treatment_of_Glaucoma. July 11, 2019. Accessed August 9, 2019.
2. Venkata V, Parth S, Oshin R, et al. Outcomes of micropulse transscleral cyclophotocoagulation in eyes with good central vision. J Glaucoma. August 2, 2019. [Epub ahead of print].