Surgical Treatment of Primary Open-angle Glaucoma Using Micropulse Laser Exposure

Purpose . Analysis of the results of micropulse transscleral cyclophotocoagulation in patients with primary open-angle glaucoma. Materiales and methods . The study analyzed medical records of 91 patients with primary open-angle glaucoma (POAG) stages II–IV in 93 eyes. Of these, 42 (46 %) were men and 49 (54 %) were women. The average age of the study participants was 70 ± 15 years. Stage II of the disease occurred in 28 % of cases, stage III — in 59 %, and stage IV — in 13 %. The initial intraocular pressure (IOP) averaged 29.0 ± 4.2 mm Hg. Corrected visual acuity was 0.2 and higher in half of the cases. All patients used two or more antihypertensive drugs, three on average. The follow-up period after micropulse transscleral cyclophotocoagulation (mCPC) was 15 months. Results . No intraoperative complications were recorded. In the early postoperative period, complications were observed in 7.6 % of patients: short-term pain syndrome — 4.3 %, an increase in IOP above the preoperative level — 3.3 % of cases. The target IOP level was achieved in 94.7 % of cases. On average, IOP after surgery was 19.0 ± 3.5 mm Hg ( p = 0.04). The number of antihypertensive drugs used decreased by 27 % (to 2.2 on average). Visual acuity remained stable in 100 % of cases, and subsequently increased in 6 patients (6.5 %), after cataract phacoemulsification with intraocular lens implantation. Conclusion . Our experience with mCFC has confirmed the effectiveness of the method in reducing and maintaining IOP at target values, as well as in reducing the number of antihypertensive drugs used. The method has proven its safety and effectiveness with a low number of complications.