Long-Term Follow-Up Results Of Transscleral Micropulse Laser Cyclophotocoagulation In Patients With Advanced Glaucoma

Evaluation of the long-term efficacy of transscleral micropulse laser cyclophotocoagulation (TMLS) in advanced glaucoma cases.

Çukurova University School of Medicine, Turkey.

The study included 28 patients who underwent 180° or 360° TMLS treatment due to advanced glaucoma resistant to medical therapy. Patients underwent a detailed ophthalmological examination and intraocular pressure (IOP) measurement using Goldmann applanation tonometry. Additional TMLS was performed on patients who continued to have elevated IOP despite medical therapy during follow-up after TMLS. Patients were followed up for at least one year after the initial TMLS procedure. Surgical success was defined as achieving IOP ≤21 mmHg (with or without antiglaucoma therapy) and/or achieving a ≥20% reduction in IOP. 

The mean age of patients was 55.4±19.5 years. The mean follow-up period was 17.7±8 months. TMLS treatment was administered twice to 15 eyes and three times to 2 eyes. The mean preoperative IOP values were 32.25±9 mmHg. Mean IOP values were 24±8.3 mmHg on the first day after surgery, 20.5±11.4 in the first week, 22.5±10.2 at first month, 22±8.7 at third month, and 20.4±9.9 at sixth month, 21.6±10.9 at 9 months, and 19.8±8 at 12 months, which were lower than preoperative values (p<0.05 for all). Treatment efficacy was maintained in 24 cases (85.7%) at 12 months postoperative (10 cases treated twice, 1 case treated three times with TMLS), and a decrease of 14.5±5.6 mmHg was observed compared to preoperative values (31.5±9.1 mmHg) (p=0.001). 

TMLS is a safe method for advanced glaucoma cases that are resistant to treatment, and its effectiveness in lowering intraocular pressure can continue up to 12 months after the procedure.