Micropulse Laser Trabeculoplasty in Glaucoma: Efficacy and Safety in a Clinical Cohort

<i>Background and Objectives</i>: Glaucoma is a leading cause of irreversible blindness, and lowering intraocular pressure (IOP) is the only proven strategy to slow disease progression. We evaluated the clinical efficacy and safety of Micropulse Laser Trabeculoplasty (MLT) in patients with open-angle glaucoma and ocular hypertension, focusing on IOP control, visual function, and adverse events. <i>Materials and Methods</i>: This longitudinal, real-world cohort included 80 patients (132 eyes) treated with MLT between 2018 and 2025 at the Ophthalmology Clinic of the County Emergency Hospital, Bihor. Micropulse laser trabeculoplasty was applied over 360°, except in selected cases (90-300°), depending on anatomical or clinical factors. Outcomes included IOP by Goldmann and non-contact tonometry, best-corrected visual acuity (BCVA), refraction, and safety events. Pre-/post comparisons used paired tests and McNemar's exact test where appropriate. <i>Results</i>: IOP decreased from 18.15 ± 5.02 to 15.57 ± 3.78 mmHg at 3 months (mean reduction: 2.58 mmHg, <i>p</i> < 0.001), confirmed by GEE adjusted for age, sex, and eye laterality. The proportion of eyes within target ranges increased significantly (IOP ≤ 18 mmHg and ≤21 mmHg; <i>p</i> = 0.0014 and <i>p</i> = 0.0023, respectively). A total of 31.1% of eyes achieved ≥ 20% IOP reduction, and 31.8% had an absolute decrease > 3 mmHg. BCVA and refraction remained stable (<i>p</i> > 0.05). No major complications or IOP spikes > 5 mmHg occurred; transient, self-limited events were uncommon. <i>Conclusions</i>: MLT was associated with a safe and clinically relevant reduction in IOP in patients with open-angle glaucoma and ocular hypertension, with stable visual function and minimal adverse effects observed. These results suggest that MLT may be a useful option for IOP management; however, the lack of a control group limits causal interpretation. Further controlled studies are warranted to confirm these findings.