An Analysis The Results Of Treatment For Primary Open-Angle Glaucoma Using Micropulse Laser Trabeculoplasty

To evaluate the effectiveness of treating primary open-angle glaucoma (POAG) using MLT with a laser device at a wavelength of 577 nm for 360° exposure.

All examinations and surgeries were carried out at the Republican Specialized Scientific Practical Medical Center of Microsurgery of the Eye and at the Sihat Ko'z Clinic with the informed consent of the patients in accordance with the ethical standards of the Declaration of Helsinki of 1975 and its revised version of 2000.

The examination included 54 patients (62 eyes) with unstabilized POAG divided into two groups. The 1st group (21 patients (26 eyes)) underwent SLT, and the 2nd group (33 patients (36 eyes)) underwent MLT. The MLT group was further divided into 2 subgroups: 14 patients (15 eyes) underwent MLT with a power of 1000 mW, duty cycle of 10%; and 19 patients (21 eyes) underwent MLT with a power of 1000 mW, duty cycle of 15%. The age of the patients ranged from 40 to 78 years. The average age of patients was: SLT group – 62 years; MLT with a duty cycle of 15% - 56; with a duty cycle of 10% - 61. There were 32 women and 22 men. Most patients had stage II primary open-angle glaucoma - 63%, with 37% having stage I primary open-angle glaucoma.

The mean pretreatment IOP values were similar in the SLT and MLT groups, but one hour after SLT-5 patients (24%) experienced a pressure increase greater than 3 mmHg. Conversely, in the MLT group an hour later, there was a decrease in IOP.

At the 6-month follow-up, the SLT and MLT groups with a duty cycle of 15% exhibited similar success, with a reduction in IOP values of more than 20% from the baseline, at 71% and 78%, respectively. In the MLT group with a duty cycle of 10%, this indicator significantly differed from the first two groups, with a decrease in IOP to target values observed in only 33% of cases.

Similar trends were observed in perimetry results.

78% of patients received antihypertensive drops before laser treatment

For the treatment of primary open-angle glaucoma (POAG), MLT emerges as a novel method that operates without causing thermal damage to the pigment cells of the trabecular meshwork. However, to achieve optimal treatment effects, the impact power must be set at 1000 mW, and the duty cycle should be 15%. This was evidenced by a substantial decrease in IOP over a 6-month observation period. Importantly, the group of patients undergoing MLT reported no discomfort during and after treatment, and there were no spikes in IOP following the laser procedure compared to the group receiving SLT.