Outcomes of micropulse transscleral cyclophotocoagulation using different sweep velocity in the treatment of refractory glaucoma

Abstract

This study compared the efficacy and safety of micropulse transscleral cyclophotocoagulation (MP-TSCPC) using different sweep velocities in refractory glaucoma. Twenty-eight eyes of 28 patients were treated with a slow-sweep protocol (20 s × 4 sweeps per hemisphere, fluence = 104.8 J/cm²), and 29 eyes of 26 patients were treated with a regular-sweep protocol (10 s × 8 sweeps per hemisphere, fluence = 52.4 J/cm²). Patients were evaluated at 1, 3, and 6 months to assess intraocular pressure (IOP), best-corrected visual acuity (BCVA), number of medications, and complications. The regular-sweep group achieved significantly greater mean IOP reduction at 1 month (–12.1 vs. − 4.8 mmHg, P < 0.001) and 3 months (–10.5 vs. − 3.6 mmHg, P = 0.003). At 6 months, no significant change in BCVA from baseline was observed in either group (all P > 0.05), while both protocols significantly reduced topical IOP-lowering medication use (all P < 0.05). Complication rates did not differ significantly between groups (P = 0.738). Multivariable analysis identified higher baseline IOP (P = 0.005) and the regular-sweep protocol (P < 0.001) as predictors of greater IOP reduction. In refractory glaucoma, both regular- and slow-sweep velocity protocols of MP-TSCPC demonstrated effectiveness with a similar safety profile in IOP reduction after a short follow-up period.