Effectiveness of Micropulse Transscleral Cyclophotocoagulation (MP-TSCPC) Using the Longer Duration Protocol in Lowering IOP in Patients with Glaucoma

Doi: 10.36351/pjo.v42i2.2205

Abstract

Purpose:  To evaluate the short-term effectiveness and associated predictors of intraocular pressure (IOP) reduction following micropulse transscleral cyclophotocoagulation (MP-TSCPC) in patients with glaucoma.

Study Design:  Prospective observational study.

Place and Duration of Study:  Conducted at Liaquat National Hospital, Karachi, from July 12, 2024, to January 13, 2025.

Methods:  Patients with uncontrolled glaucoma undergoing MP-TSCPC were enrolled. IOP was measured at baseline, 1 month, and 3 months post-procedure. Treatment effectiveness was defined as a ≥20% reduction in IOP without need for further surgical intervention. Friedman test and Wilcoxon signed-rank tests assessed changes over time. Categorical associations were examined using chi-square test, and predictors of effectiveness were analyzed via univariate and multivariable logistic regression.

Results:  A total of 97 eyes were analyzed. Median baseline IOP was 20 mmHg (IQR: 17–31), which significantly reduced to 16 mmHg (IQR: 14–22) at 1 month and 14 mmHg (IQR: 11–17) at 3 months (p < 0.001). Treatment was effective in 76 eyes (78.4%). Male gender (p < 0.001), longer glaucoma duration (p = 0.03), and moderate severity (p = 0.038) were significantly associated with effectiveness. In multivariable regression, only male gender remained an independent predictor (aOR = 10.59, 95% CI: 2.11–53.21, p = 0.004).

Conclusion:  MP-TSCPC significantly lowered IOP at 1 and 3 months. Approximately four-fifths of patients achieved effective outcomes, with male gender being a strong predictor of success. The procedure appears safe and beneficial for short-term glaucoma control.