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Micropulse cyclophotocoagulation: an update on a novel glaucoma treatment

Author(s):

Michael Giovingo

Krishna B. Patel

Elizabeth A. Martin

Mitchell J. Greenberg

John Samples

Paul Knepper

Thomas D. Patrianakos

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Abstract:

Purpose: To discuss the efficacy and complications of micropulse cyclophotocoagulation (MPCPC) in the treatment of glaucoma and compare it to more commonly used glaucoma interventions.
Summary: MPCPC presents an innovative new tool for the treatment of glaucoma. It gives us a minimally invasive, blebless, repeatable procedure that allows for reduction of intraocular pressure (IOP) through partially physiologic methods. The main advantage to this procedure over its predecessor, continuous-wave cyclophotocoagulation (CWCPC), is its low inflammatory nature. MPCPC has a lower complication rate and delivers a similar reduction in IOP compared to CWCPC. Over time, the technique for laser application has changed, improving outcomes. Moving the anterior edge of the probe 2 mm posterior to the limbus improves outcomes from both an IOP lowering and complication standpoint. This position leads to less mydriasis and less damage to the limbal stem cells. In order to maximize outcome, the clinician must be very detail-oriented in a procedure that superficially seems quite simple. MPCPC provides a new tool for the glaucoma specialist to treat patients with moderate to severe disease. Its blebless nature allows for very little change in lifestyle; i.e., swimming, contact lens use, active lifestyle. When performed properly, it is highly successful, and in case of failure, it does not interfere if incisional surgery is indicated.

Glaucoma Research 2018-2020, pp. 271-281 #19
Edited by: John R. Samples and Paul A. Knepper
© Kugler Publications, Amsterdam, The Netherlands

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