Efficacy And Safety Of Combined Continuous-Wave And Micropulse Transscleral Cyclophotocoagulation In Resistant Glaucoma
Published 2026 - 44th Congress of the ESCRS
Reference: FP28.03 | Type: Free paper | DOI: 10.82333/yt9k-wp90
Authors: Prof. Dr Ahmed Hassan Aldghaimy* 1 , Dr Ahmed Seifelnasr Mahmoud 1 , A/Prof. Ahmed abd allah mohalhal soliman 2 , Dr Osama abd almoneim elsoghair 1
1Ophthalmology ,Qena university hospital ,Qena ,Egypt, 2Ophthalmology ,Cairo university hospital ,Qena ,Egypt
Purpose
Background: Glaucoma is a leading cause of irreversible blindness worldwide, with intraocular pressure (IOP) being the only modifiable risk factor. Continuous-wave transscleral cyclophotocoagulation (CW-TSCPC) effectively lowers IOP but is associated with significant complications, whereas micropulse TSCPC offers improved safety through reduced thermal damage. Combining both techniques may enhance efficacy while minimizing adverse effects in resistant glaucoma.
Aim: To evaluate the efficacy and safety of combined continuous-wave and micropulse transscleral diode laser cyclophotocoagulation in patients with resistant glaucoma.
Setting
The study was conducted at Qena University hospital and private ophthalmological center in Egypt from October 2024 to Augest 2025 .
Methods
This prospective interventional study included 40 eyes of 40 adults with uncontrolled glaucoma unsuitable for conventional surgery. All patients underwent combined 810-nm CW and micropulse TSCPC under retrobulbar anesthesia. Treatment success was defined as ≥20% IOP reduction from baseline or IOP ≤18 mmHg on two consecutive visits. Patients were followed for six months, and postoperative outcomes and complications were recorded.
Results
The mean age of patients was 53.3 ± 7.5 years. Mean preoperative IOP significantly decreased from 34.5 ± 2.4 mmHg to 18.4 ± 6.2 mmHg at six months (P < 0.0001), representing a 46.5% reduction. Surgical success was achieved in 85% of eyes. Best-corrected visual acuity remained stable (P = 0.24). Reported complications were mild and transient, including mydriasis (12.5%), uveitis (10%), and cataract progression (5%). No cases of persistent hypotony or phthisis bulbi were observed.
Conclusions
Combined continuous-wave and micropulse TSCPC is a safe and effective treatment option for resistant glaucoma, providing substantial and sustained IOP reduction with a high success rate and minimal complications while preserving visual acuity.