Chavez Matheus P, Guedes Guilherme B, Pasqualotto Eric, de Almeida Izabela N F, Lopes Lucca M, Prata Tiago S, de Souza Tiago T
Department of Ophthalmology, Universidade Federal de Santa Catarina, Florianópolis, SC.
Department of Ophthalmology, Hospital de Olhos do Paraná, Curitiba, PR.
J Glaucoma. 2025 Aug 1;34(8):575-584. doi: 10.1097/IJG.0000000000002583. Epub 2025 Apr 29.
Micropulse transscleral laser treatment (MP-TLT) and continuous wave transscleral cyclophotocoagulation demonstrated comparable intraocular pressure across all follow-ups. MP-TLT was associated with significantly lower risks of ocular complications, such as hypotony, prolonged inflammation, and phthisis bulbi.
To compare the efficacy and safety of micropulse transscleral laser treatment (MP-TLT) and continuous wave transscleral cyclophotocoagulation (CW-TSCPC) for the treatment of glaucoma or ocular hypertension.
A systematic search was conducted in PubMed, Cochrane Library, Embase, and ClinicalTrials.gov. Randomized controlled trials (RCTs) or cohort studies comparing MP-TLT and CW-TSCPC were included. Weighted mean differences (MDs) were computed for continuous endpoints and risk ratios (RRs) for binary endpoints, with 95% CIs. Heterogeneity was assessed with I2 statistics. Software R, version 4.4.0, was used for statistical analyses. Subgroup analyses were conducted on glaucoma types.
Eleven studies encompassing 1054 eyes from 986 patients were included, with 47.4% receiving MP-TLT. There were no significant differences in IOP between CW-TSCPC and MP-TLT at 1 week, 1 month, 3 months, 6 months, 12 months, and 18 months of follow-up. The MP-TLT group required a significantly higher number of hypotensive medications but displayed significantly reduced risks of overall complications, ocular hypotony, prolonged inflammation, and phthisis bulbi compared with CW-TSCPC.
MP-TLT and CW-TSCPC showed similar efficacy in IOP control. However, MP-TLT demonstrated a greater safety profile, suggesting its potential suitability for patients requiring repeat interventions or those with lower tolerance for ocular complications.
比较微脉冲经巩膜激光治疗（MP-TLT）和连续波经巩膜睫状体光凝术（CW-TSCPC）治疗青光眼或高眼压症的疗效和安全性。
在PubMed、Cochrane图书馆、Embase和ClinicalTrials.gov进行系统检索。纳入比较MP-TLT和CW-TSCPC的随机对照试验（RCT）或队列研究。计算连续终点的加权平均差（MD）和二分类终点的风险比（RR），并给出95%置信区间。用I²统计量评估异质性。使用R软件4.4.0版进行统计分析。对青光眼类型进行亚组分析。
纳入11项研究，共986例患者的1054只眼，47.4%接受MP-TLT。在随访1周、1个月、3个月、6个月、12个月和18个月时，CW-TSCPC和MP-TLT之间的眼压无显著差异。与CW-TSCPC相比，MP-TLT组所需降压药物数量显著更多，但总体并发症、低眼压、炎症持续时间和眼球痨的风险显著降低。
MP-TLT和CW-TSCPC在眼压控制方面显示出相似的疗效。然而，MP-TLT显示出更高的安全性，表明它可能适用于需要重复干预的患者或对眼部并发症耐受性较低的患者。
微脉冲经巩膜激光治疗（MP-TLT）和连续波经巩膜睫状体光凝术在所有随访中眼压相当。MP-TLT与眼部并发症风险显著降低相关，如低眼压、炎症持续时间延长和眼球痨。
