Jiravarnsirikul A.Jiamjira-Anon N.Ruangvaravate N.Sakiyalak D.Kitnarong N.Phongsuphan T.Sermsripong W.Petchyim S.Mahidol University2026-01-092026-01-092025-12-01Scientific Reports Vol.15 No.1 (2025)https://repository.li.mahidol.ac.th/handle/123456789/113966This 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.MultidisciplinaryArticleSCOPUS10.1038/s41598-025-28423-62-s2.0-1050262138682045232241462358