Sandhur Baltaj S, Jethi Mohit, Gautam Natasha, Ersan Sinan, Jay Logan, Sieminski Sandra F
Department of Ophthalmology, Jacobs School of Medicine and Biomedical Sciences, Buffalo, United States.
Ross Eye Institute, Buffalo, United States.
Lasers Med Sci. 2025 Sep 20;40(1):370. doi: 10.1007/s10103-025-04631-4.
Slow-coagulation continuous wave cyclophotocoagulation (SC-CWCPC) is a promising treatment option for refractory glaucoma. However, its efficacy following a failed MicroPulse transscleral cyclophotocoagulation (MP-TSCPC) procedure remains unexplored. This study evaluates the efficacy of SC-CWCPC in patients with uncontrolled intraocular pressure (IOP) after undergoing MP-TSCPC. A retrospective case series of patients with uncontrolled glaucoma who underwent SC-CWCPC following MP-TSCPC failure was conducted. All procedures were performed by a single glaucoma surgeon between January 2022 And October 2024. Patients with < 3 months follow-up were excluded. SC-CWCPC was performed using 1250-milliwatt power and 4-second applications. Surgical success was defined as IOP between 6 and 21 mmHg with a ≥ 20% reduction from baseline on topical medication, no incisional reoperation for glaucoma, and no loss of light perception vision. Eight patients (10 eyes) with a mean age of 43.75 ± 24.59 years were included. 90% (9/10) had prior Tube/Trabeculectomy procedures. Mean preoperative IOP was 26.10 ± 15.80 mmHg on 3.1 ± 1.20 antiglaucoma medications (AGM). At a mean follow up time of 10.97 ± 3.42 months, IOP decreased to 15.80 ± 5.31 mmHg (p = 0.002) with 2.30 ± 1.49 AGM (p = 0.070) with an overall success rate of 80%. One eye required Ahmed Glaucoma Valve implantation one year postoperatively while another had prolonged inflammation that resolved medically. No cases of persistent hypotony or significant visual acuity loss occurred. SC-CWCPC is an effective and safe surgical intervention in patients with refractory glaucoma following failed MP-TSCPC. The results of our study are helpful in expanding the role of the SC-CWCPC technique in the management of glaucomatous patients.
慢凝连续波睫状体光凝术（SC-CWCPC）是难治性青光眼一种有前景的治疗选择。然而，在微脉冲经巩膜睫状体光凝术（MP-TSCPC）失败后的疗效仍未得到探索。本研究评估SC-CWCPC对MP-TSCPC术后眼压控制不佳患者的疗效。对MP-TSCPC失败后接受SC-CWCPC的难治性青光眼患者进行回顾性病例系列研究。所有手术均由一名青光眼外科医生在2022年1月至2024年10月期间进行。排除随访时间<3个月的患者。SC-CWCPC采用1250毫瓦功率和4秒照射时间进行。手术成功定义为眼压在6至21 mmHg之间，局部用药时较基线降低≥20%，无需因青光眼进行切口再手术，且无光感丧失。纳入8例患者（10只眼），平均年龄43.75±24.59岁。90%（9/10）曾接受过引流管/小梁切除术。术前平均眼压为26.10±15.80 mmHg，使用3.1±1.20种抗青光眼药物（AGM）。平均随访时间为10.97±3.42个月时，眼压降至15.80±5.31 mmHg（p = 0.002），使用2.30±1.49种AGM（p = 0.070），总体成功率为80%。一只眼术后一年需要植入艾哈迈德青光眼引流阀，另一只眼有持续性炎症，经药物治疗后消退。未发生持续性低眼压或明显视力丧失病例。SC-CWCPC是MP-TSCPC失败后难治性青光眼患者一种有效且安全的手术干预措施。我们的研究结果有助于扩大SC-CWCPC技术在青光眼患者管理中的作用。
