Outcomes of Micropulse Transscleral Cyclophotocoagulation in Eyes With Good Central Vision

Venkata N.V. Varikuti, Parth Shah, Oshin Rai, Ariel C. Chaves, Alex Miranda, Boon Ang Lim, Syril K. Dorairaj, Sandra F. Sieminski

Research output: Contribution to journalArticle

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Abstract

Precis:This study is the first to report micropulse transscleral cyclophotocoagulation (MP-TSCPC) use in only good vision patients. MP-TSCPC significantly reduced intraocular pressure (IOP) and glaucoma medication use without any significant reduction in visual acuity at every postoperative follow-up point.Purpose:To evaluate outcomes of MP-TSCPC in eyes with baseline best-corrected visual acuity (BCVA) of ≥20/60.Methods:A retrospective review of patients who underwent MP-TSCPC at Mayo Clinic and Ross Eye Institute from July 2016 to August 2017 with BCVA of ≥20/60, and a minimum of 3 months follow-up.Results:A total of 61 eyes of 46 patients (68.80±17.12 y) underwent MP-TSCPC with a mean follow-up of 10.2±3.1 months. Mean IOP and mean number of glaucoma medications used were significantly reduced from baseline at every follow-up time point (P<0.0001). At month 12, mean IOP was reduced 40.2% from baseline with 85.4% of the patients having an IOP reduction of ≥20%, and mean glaucoma medication use reduced by 0.82±0.53 with 79.6% of the patients having a reduction of ≥1 medication. There was no significant reduction in BCVA from baseline at any follow-up point (P>0.05), except for 10 eyes with a vision loss of ≥2 lines and 5 out of 10 eyes had cataract progression. The probability of complete success (IOP range, 6 to 21 mm Hg or ≥20% IOP reduction; BCVA loss ≤2 lines, no reoperation for glaucoma) was 74.14%, 83.61%, 84.21%, and 75.0% at months 1, 3, 6, 12, respectively. The probability of qualified success (above criteria for IOP, no reoperation and BCVA loss >2 lines) was 81.03%, 91.80%, 94.74%, and 93.75% at months 1, 3, 6, 12, respectively.Conclusions:MP-TSCPC should be considered earlier in the management of glaucoma and can possibly be offered as an alternative to incisional glaucoma surgeries.

Original languageEnglish (US)
Pages (from-to)901-905
Number of pages5
JournalJournal of glaucoma
Volume28
Issue number10
DOIs
StatePublished - Oct 1 2019

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Intraocular Pressure
Glaucoma
Visual Acuity
Reoperation
Cataract

Keywords

  • best correct visual acuity
  • cyclodestruction
  • intraocular pressure
  • micropulse transscleral cyclophotocoagulation
  • primary open-angle glaucoma

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Varikuti, V. N. V., Shah, P., Rai, O., Chaves, A. C., Miranda, A., Lim, B. A., ... Sieminski, S. F. (2019). Outcomes of Micropulse Transscleral Cyclophotocoagulation in Eyes With Good Central Vision. Journal of glaucoma, 28(10), 901-905. https://doi.org/10.1097/IJG.0000000000001339

Outcomes of Micropulse Transscleral Cyclophotocoagulation in Eyes With Good Central Vision. / Varikuti, Venkata N.V.; Shah, Parth; Rai, Oshin; Chaves, Ariel C.; Miranda, Alex; Lim, Boon Ang; Dorairaj, Syril K.; Sieminski, Sandra F.

In: Journal of glaucoma, Vol. 28, No. 10, 01.10.2019, p. 901-905.

Research output: Contribution to journalArticle

Varikuti, VNV, Shah, P, Rai, O, Chaves, AC, Miranda, A, Lim, BA, Dorairaj, SK & Sieminski, SF 2019, 'Outcomes of Micropulse Transscleral Cyclophotocoagulation in Eyes With Good Central Vision', Journal of glaucoma, vol. 28, no. 10, pp. 901-905. https://doi.org/10.1097/IJG.0000000000001339
Varikuti, Venkata N.V. ; Shah, Parth ; Rai, Oshin ; Chaves, Ariel C. ; Miranda, Alex ; Lim, Boon Ang ; Dorairaj, Syril K. ; Sieminski, Sandra F. / Outcomes of Micropulse Transscleral Cyclophotocoagulation in Eyes With Good Central Vision. In: Journal of glaucoma. 2019 ; Vol. 28, No. 10. pp. 901-905.
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abstract = "Precis:This study is the first to report micropulse transscleral cyclophotocoagulation (MP-TSCPC) use in only good vision patients. MP-TSCPC significantly reduced intraocular pressure (IOP) and glaucoma medication use without any significant reduction in visual acuity at every postoperative follow-up point.Purpose:To evaluate outcomes of MP-TSCPC in eyes with baseline best-corrected visual acuity (BCVA) of ≥20/60.Methods:A retrospective review of patients who underwent MP-TSCPC at Mayo Clinic and Ross Eye Institute from July 2016 to August 2017 with BCVA of ≥20/60, and a minimum of 3 months follow-up.Results:A total of 61 eyes of 46 patients (68.80±17.12 y) underwent MP-TSCPC with a mean follow-up of 10.2±3.1 months. Mean IOP and mean number of glaucoma medications used were significantly reduced from baseline at every follow-up time point (P<0.0001). At month 12, mean IOP was reduced 40.2{\%} from baseline with 85.4{\%} of the patients having an IOP reduction of ≥20{\%}, and mean glaucoma medication use reduced by 0.82±0.53 with 79.6{\%} of the patients having a reduction of ≥1 medication. There was no significant reduction in BCVA from baseline at any follow-up point (P>0.05), except for 10 eyes with a vision loss of ≥2 lines and 5 out of 10 eyes had cataract progression. The probability of complete success (IOP range, 6 to 21 mm Hg or ≥20{\%} IOP reduction; BCVA loss ≤2 lines, no reoperation for glaucoma) was 74.14{\%}, 83.61{\%}, 84.21{\%}, and 75.0{\%} at months 1, 3, 6, 12, respectively. The probability of qualified success (above criteria for IOP, no reoperation and BCVA loss >2 lines) was 81.03{\%}, 91.80{\%}, 94.74{\%}, and 93.75{\%} at months 1, 3, 6, 12, respectively.Conclusions:MP-TSCPC should be considered earlier in the management of glaucoma and can possibly be offered as an alternative to incisional glaucoma surgeries.",
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AU - Varikuti, Venkata N.V.

AU - Shah, Parth

AU - Rai, Oshin

AU - Chaves, Ariel C.

AU - Miranda, Alex

AU - Lim, Boon Ang

AU - Dorairaj, Syril K.

AU - Sieminski, Sandra F.

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N2 - Precis:This study is the first to report micropulse transscleral cyclophotocoagulation (MP-TSCPC) use in only good vision patients. MP-TSCPC significantly reduced intraocular pressure (IOP) and glaucoma medication use without any significant reduction in visual acuity at every postoperative follow-up point.Purpose:To evaluate outcomes of MP-TSCPC in eyes with baseline best-corrected visual acuity (BCVA) of ≥20/60.Methods:A retrospective review of patients who underwent MP-TSCPC at Mayo Clinic and Ross Eye Institute from July 2016 to August 2017 with BCVA of ≥20/60, and a minimum of 3 months follow-up.Results:A total of 61 eyes of 46 patients (68.80±17.12 y) underwent MP-TSCPC with a mean follow-up of 10.2±3.1 months. Mean IOP and mean number of glaucoma medications used were significantly reduced from baseline at every follow-up time point (P<0.0001). At month 12, mean IOP was reduced 40.2% from baseline with 85.4% of the patients having an IOP reduction of ≥20%, and mean glaucoma medication use reduced by 0.82±0.53 with 79.6% of the patients having a reduction of ≥1 medication. There was no significant reduction in BCVA from baseline at any follow-up point (P>0.05), except for 10 eyes with a vision loss of ≥2 lines and 5 out of 10 eyes had cataract progression. The probability of complete success (IOP range, 6 to 21 mm Hg or ≥20% IOP reduction; BCVA loss ≤2 lines, no reoperation for glaucoma) was 74.14%, 83.61%, 84.21%, and 75.0% at months 1, 3, 6, 12, respectively. The probability of qualified success (above criteria for IOP, no reoperation and BCVA loss >2 lines) was 81.03%, 91.80%, 94.74%, and 93.75% at months 1, 3, 6, 12, respectively.Conclusions:MP-TSCPC should be considered earlier in the management of glaucoma and can possibly be offered as an alternative to incisional glaucoma surgeries.

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KW - best correct visual acuity

KW - cyclodestruction

KW - intraocular pressure

KW - micropulse transscleral cyclophotocoagulation

KW - primary open-angle glaucoma

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