Shalaby Wesam S, Arbabi Amirmohsen, Wong Jae-Chiang, Shukla Aakriti G, Razeghinejad Reza, Lee Daniel, Moster Marlene R, Myers Jonathan S, Kolomeyer Natasha N
Department of Glaucoma, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, United States; Department of Glaucoma, Tanta Medical School, Tanta University, Tanta, Egypt.
Department of Glaucoma, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
J Curr Glaucoma Pract. 2025 Jan-Mar;19(1):8-14. doi: 10.5005/jp-journals-10078-1466. Epub 2025 Mar 24.
To compare the risk of early intraocular pressure (IOP) spikes following micropulse (MP) vs continuous wave (CW) transscleral cyclophotocoagulation (CPC).
Single-center, prospective, nonrandomized study that included glaucoma patients planned for MP- or CW-CPC at Wills Eye Hospital (2020-2021). IOP was measured using rebound tonometry (iCare) immediately before, immediately after, and 1 hour after the CPC, then on postoperative day 1. The primary outcome measure was the incidence of IOP spikes, defined as IOP elevation ≥10 mm Hg vs baseline. Patients with severe IOP spikes received IOP-lowering agents (topical or oral).
Twenty-six eyes (15 CW and 11 MP) of 26 patients were included, with a mean age of 64.4 ± 15.1 years. At the baseline visit, IOP was 29.5 ± 11.3 mm Hg, and the medication number was 3.8 ± 1.4, with no difference between groups. IOPs (CW vs MP, mm Hg) were 31.9 ± 10.5 vs 24.1 ± 7.3 immediately before CPC ( = 0.044), 22.9 ± 10.8 vs 16.1 ± 6.3 immediately after CPC ( = 0.760), 24.6 ± 11.9 vs 23.2 ± 9.5 at 1 hour after CPC ( = 0.757), and 18.0 ± 6.1 vs 20.8 ± 6.9 at 1 day later ( = 0.335). Three eyes (11.5%; 1 CW, 2 MP) experienced IOP spikes ( = 0.556) at 1 hour post-CPC; IOP responded to topical and/or oral medications. At day 1 and month 1, mean IOP reduction compared to baseline was significant in CW eyes ( < 0.001) and insignificant in MP eyes ( > 0.05).
MP- and CW-CPC have similar risks of early postoperative IOP spikes. Significant early IOP reduction was better achieved following CW-CPC. Early postoperative IOP spikes may be detrimental; there may be a role for IOP monitoring in such cases.
Understanding the early postoperative outcomes of MP- and CW-CPC is critical for optimizing glaucoma management. This study highlights that while both procedures carry a similar risk of early IOP spikes, CW-CPC demonstrates superior early IOP reduction. These insights help clinicians tailor CPC strategies to individual patient requirements.
Shalaby WS, Arbabi A, Wong J, . Early Postoperative Intraocular Pressure Profile Following Micropulse vs Continuous Wave Transscleral Cyclophotocoagulation: Cohort Study. J Curr Glaucoma Pract 2025;19(1):8-14.
比较微脉冲（MP）与连续波（CW）经巩膜睫状体光凝术（CPC）后早期眼压（IOP）升高的风险。
这是一项单中心、前瞻性、非随机研究，纳入了2020 - 2021年在威尔斯眼科医院计划接受MP - CPC或CW - CPC的青光眼患者。在CPC术前即刻、术后即刻和术后1小时，然后在术后第1天，使用回弹式眼压计（iCare）测量眼压。主要观察指标是眼压升高的发生率，定义为眼压较基线升高≥10 mmHg。眼压严重升高的患者接受降眼压药物治疗（局部或口服）。
纳入了26例患者的26只眼（15只CW组和11只MP组），平均年龄为64.4±15.1岁。在基线检查时，眼压为29.5±11.3 mmHg，用药数量为3.8±1.4，两组之间无差异。CPC术前即刻眼压（CW组与MP组，mmHg）分别为31.9±10.5和24.1±7.3（P = 0.044），CPC术后即刻分别为22.9±10.8和16.1±6.3（P = 0.760），CPC术后1小时分别为24.6±11.9和23.2±9.5（P = 0.757），术后1天分别为18.0±6.1和20.8±6.9（P = 0.335）。3只眼（11.5%；1只CW组，2只MP组）在CPC术后1小时出现眼压升高（P = 0.556）；眼压对局部和/或口服药物有反应。在术后第1天和第1个月，与基线相比，CW组眼压平均降低显著（P < 0.001），而MP组不显著（P > 0.05）。
MP - CPC和CW - CPC术后早期眼压升高的风险相似。CW - CPC术后早期眼压显著降低效果更好。术后早期眼压升高可能有害；在这种情况下眼压监测可能有作用。
了解MP - CPC和CW - CPC术后早期结果对于优化青光眼治疗至关重要。本研究强调，虽然两种手术早期眼压升高风险相似，但CW - CPC在早期眼压降低方面表现更优。这些见解有助于临床医生根据个体患者需求制定CPC策略。
Shalaby WS, Arbabi A, Wong J, 等。微脉冲与连续波经巩膜睫状体光凝术后早期眼压情况：队列研究。《当代青光眼实践杂志》2025；19(1):8 - 14。
