Micropulse Transscleral Cyclophotocoagulation for the Management of Diverse Glaucoma Types: A Multicenter Short-Term Real-World Study

Núbia Vanessa dos Anjos Lima,1,* Nara Lidia Vieira Lopes,2,* Heloisa Andrade Maestrini,3,* Heloisa Helena Abil Russ Giacometti,4,* Taurino dos Santos Rodrigues Neto,5,* Luiz Paulo Dias Mario,6,* Thatiana Almeida Pereira Fernandes,3,* Marcos Balbino,7,* Regina Cele Silveira Seixas,5,* Lunna Pires Moreira8,* 1Department of Ophthalmology, UniCeub – Brasília, Brasília, DF, Brazil; 2Department of Ophthalmology, Hospital de Olhos-CBV – VisionOne, Brasília, DF, Brazil; 3Department of Ophthalmology, Hospital Oculare, Belo Horizonte, MG, Brazil; 4Department of Ophthalmology, HR Oftalmologia, Curitiba, PR, Brazil; 5Department of Ophthalmology, Grupo OPTY – HCLOE Oftalmologia Especializada, São Paulo, SP, Brazil; 6Department of Ophthalmology, Universidade de Santo Amaro – UNISA, São Paulo, SP, Brazil; 7Department of Medicine, Centro Universitário São Camilo, São Paulo, SP, Brazil; 8Department of Ophthalmology, Próvisão – Clínica de Olhos Do Litoral Paranaense, Paranaguá, PR, Brazil*All these authors contributed equally to this workCorrespondence: Marcos Balbino, Department of Medicine, Centro Universitário São Camilo, São Paulo, Brazil, Avenida Nazaré 1501, São Paulo, SP, 04263200, Brazil, Tel +551198346, Email [email protected]; [email protected]: To evaluate the safety and effectiveness of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in patients with various types of glaucoma by assessing intraocular pressure (IOP) reduction, medication burden, and the potential influence of diagnosis, prior surgeries, or comorbidities on treatment success.Patients and Methods: This retrospective, multicenter study included 101 eyes treated with MP-TSCPC using the IRIDEX Cyclo G6 MP3 laser. Follow-up was performed for at least 12 months. The primary outcomes were IOP reduction and changes in the number of hypotensive medications. The secondary outcomes included complication rates and visual acuity stability. Success was defined as IOP reduction ≥ 20% or IOP between 6 and 21 mmHg, with or without medication. Statistical analyses included paired t-tests and Cox regression to assess subgroup influence.Results: Baseline intraocular pressure (IOP) was 26.19 ± 6.77 mmHg and decreased to 14.40 ± 6.10 mmHg at 12 months (Δ = − 11.76 ± 8.03 mmHg; ≈ − 45%; p< 0.0001). Mean logMAR visual acuity changed from 0.53 ± 0.64 preoperatively to 0.63 ± 0.72 postoperatively (p < 0.001). No significant differences in treatment success were found among the glaucoma subtypes, previous ocular surgeries, or comorbidities (all p > 0.05). Visual acuity remained stable in most patients, with only two cases of loss of light perception. Severe complications were rare, and no cases of phthisis bulbi or hypotony were observed.Conclusion: MP-TSCPC safely provides sustained IOP control and medication reduction across diverse glaucoma types, supporting its role as a versatile alternative for both refractory and functional eyes with glaucoma. The real-world, multicenter nature of this study enhances its external validity, although its retrospective design and 12-month follow-up limit long-term generalizability.Keywords: glaucoma, micropulse laser, transscleral cyclophotocoagulation, intraocular pressure, real-world data, diode laser, glaucoma treatment