The efficacy of MicroPulse Transscleral Laser Therapy as primary surgical treatment in various types of glaucoma resistant to medical treatment: a retrospective analysis

To evaluate the results of MicroPulse Transscleral Laser Therapy (TLT) as primary treatment in various types of glaucoma resistant to medical treatment. In this retrospective study, the clinical outcomes of 118 eyes from 112 patients treated with MicroPulse TLT were evaluated. Intraocular pressure (IOP) values ​​of patients with primary open-angle glaucoma (POAG), neovascular glaucoma (NVG), pseudoexfoliation glaucoma (PXG), pigmentary glaucoma (PG), angle-closure glaucoma (ACG), aphakic glaucoma (AG), congenital/juvenile glaucoma (PCG/JOAG) and silicone oil-induced glaucoma (SOG) treated with MicroPulse TLT were measured at baseline, 1 day, 1 week and 1, 3, 6 and 12 months (+/- 2 weeks) after application. 79 eyes (66.9%) received single session MicroPulse TLT, 33 eyes (28.0%) received 2 sessions, and 6 eyes (5.1%) received 3 sessions. The initial treatment demonstrated a success rate of 72.8% (n = 86). 39 patients received a subsequent treatment, which elevated the overall success rate to 75.4% (n = 89) at 12 months. Significant reductions in IOP were observed in the POAG (46.5%), NVG (50.4%), PXG (43.7%), PG (52.7%), ACG (50.6%), AG (50.8%), PCG/JOAG (56.2%) and SOG (51%) groups up to 12 months compared to baseline (p < 0.05 for each). At the end of the 12th month, a 75.4% success rate was achieved with a 48.8% decrease in mean IOP in all groups. Consequently, the overall failure rate was 24.6% (n = 29). As a primary surgical treatment, MicroPulse TLT is an effective and safe, minimally invasive treatment method that reduces IOP and drug burden in various types of glaucoma resistant to medical treatment. Further large-scale, prospective studies are recommended to validate these findings and explore long-term outcomes.