Hooshmand Sara, Voss Jackson, Hirabayashi Matthew, McDaniel Lindsey, An Jella
School of Medicine, University of Missouri, Columbia, MO, USA.
School of Medicine, University of Missouri, 3215 Wingate Court, Columbia, MO 65201, USA.
Ther Adv Ophthalmol. 2022 Feb 14;14:25158414211064433. doi: 10.1177/25158414211064433. eCollection 2022 Jan-Dec.
Micro-pulse transscleral cyclophotocoagulation (MP-TSCPC) has continued to gain popularity as a treatment in adult glaucoma patients. Thus far there is limited evidence reporting the efficaciousness and safety of retreatment.
To evaluate safety and efficacy of primary and repeat MP-TSCPC procedures.
Thirty-four of 67 eyes who failed to achieve target IOP from initial MP-TSCPC underwent repeat MP-TSCPC and followed for a minimum of 6 months. All treatments were performed using the laser power of 2000 or 2250 mW, duration of 100-200 s, and a velocity 16-20 s per hemisphere swipe. Success criteria were defined as intraocular pressure (IOP) reduction of greater than 20% from baseline or any medication reduction without additional glaucoma procedures at 6 months after repeat MP-TSCPC. The 6-month success rate after repeat MP-TSCPC was also compared to that of initial MP-TSCPC in the same group of eyes.
Mean baseline IOP before the repeat MP-TSCPC was 23.0 + /- 5.3 on 3.0 + /- 1.4 medications. At 6 months, mean post-op IOP was 18.2 + /- 5.4 (21.9% reduction, < 0.002), with mean medication staying relatively the same ( = .976). Success rate was increased from 23.5% to 44.1% with the repeat procedure compared to that of initial procedure ( = 0.123). Mean IOP reduction was also greater after repeat MP-TSCPC (18.7%, < 0.002) when compared to initial MP-TSCPC (10.4%). No adverse events occurred.
MP-TSCPC is a safe and effective non-invasive means to lower IOP in a variety of glaucoma patients. While over 50% (34/67) of eyes required repeat MP-TSCPC, repeat treatment resulted in greater success rates and IOP reduction without any adverse events when using the total energy between 112 and 150 J.
微脉冲经巩膜睫状体光凝术（MP-TSCPC）作为成人青光眼患者的一种治疗方法，越来越受到欢迎。到目前为止，关于再次治疗的有效性和安全性的证据有限。
评估初次和重复MP-TSCPC手术的安全性和有效性。
67只眼中有34只眼在初次MP-TSCPC术后未达到目标眼压，接受了重复MP-TSCPC治疗，并随访至少6个月。所有治疗均使用2000或2250 mW的激光功率、100 - 200 s的持续时间以及每半球扫描16 - 20 s的速度。成功标准定义为重复MP-TSCPC术后6个月眼压较基线降低大于20%，或在未进行额外青光眼手术的情况下任何药物用量减少。还将同一组眼中重复MP-TSCPC术后6个月的成功率与初次MP-TSCPC术后的成功率进行了比较。
重复MP-TSCPC术前的平均基线眼压为23.0 ± 5.3，使用3.0 ± 1.4种药物。6个月时，术后平均眼压为18.2 ± 5.4（降低21.9%，P < 0.002），平均药物用量相对保持不变（P = 0.976）。与初次手术相比，重复手术的成功率从23.5%提高到了44.1%（P = 0.123）。与初次MP-TSCPC（10.4%）相比，重复MP-TSCPC术后平均眼压降低幅度也更大（18.7%，P < 0.002）。未发生不良事件。
MP-TSCPC是降低各种青光眼患者眼压的一种安全有效的非侵入性方法。虽然超过50%（34/67）的眼需要重复MP-TSCPC，但当使用112至150 J的总能量时，重复治疗导致更高的成功率和眼压降低，且无任何不良事件。
