62 | EYEWORLD | AUGUST 2019
G
UCOMA
Micropulse transscleral treatment in advanced glaucoma patient performed in OR with a block
Source: Robert Noecker, MD
RESEARCH HIGHLIGHT
by Rich Daly
EyeWorld Contributing Writer
Contact
information
Noecker: noeckerrj@gmail.com
toplasty patients who received one (31 patients),
two (21 patients), three (8 patients), or four
treatments (1 patient).
1
The study used the
Cyclo G6 MicroPulse P3 (IRIDEX).
Pre-treatment, the mean IOP was 28±11
mm Hg. At 1 month post-treatment the mean
IOP was 17±7 mm Hg, at 3 months it was
17±8 mm Hg, at 6 months it was 18±9 mm Hg,
and at 12 months it was 15±5 mm Hg.
The proportions of eyes during the four
post-treatment periods with IOP ≤15 mm Hg
were 40%, 51%, 48%, and 55%, respectively.
The proportions with IOP ≤12 mm Hg were
21%, 29%, 20%, and 29%, respectively.
Six eyes (10%) received subsequent glauco-
ma filtration surgery.
The mean number of anti-glaucoma medi-
cations used before the initial treatment was 2.7
S
urgeons may consider a new treatment
for a challenging group of glaucoma
patients: pulsed transscleral cyclopho-
tocoagulation (TSCPC).
Pulsed TSCPC breaks a continu-
ous wave laser into a series of repet-
itive pulses separated by pauses that
prevent thermal buildup in the tissue. The non-
invasive procedure uses a probe placed directly
on the sclera.
The mechanism of action in the treatment
of glaucoma is not completely understood;
some effect on the ciliary body epithelium has
been demonstrated as well as some improve-
ment with uveoscleral outflow, but no gross
destruction to the ciliary body has been detect-
ed with ultrasonic biomicroscopy.
A retrospective review in Cornea evaluated
TSCPC treatments of 61 eyes in 57 post-kera-
Micropulse cyclophotocoagulation
effective in keratoplasty eyes
About the doctor
Robert Noecker, MD
Ophthalmic Consultants of
Connecticut
Clinical assistant professor of
ophthalmology
Yale University
New Haven, Connecticut
