Abstract
Purpose
This study aimed to compare and provide data on the outcomes of continuous wave (CWCPC) and micropulse transscleral cyclophotocoagulation (MPCPC).
Methods
This was a retrospective cohort study of 130 glaucomatous eyes that underwent CWCPC with a minimum 6-month follow-up matched 1:1 with 130 eyes that underwent MPCPC. The main outcome measure was CPC failure, defined as intraocular pressure (IOP) reduction of <20%, therapy advancement, or progression to no light perception. The secondary outcome measure was safety profile and complications.
Results
The mean age of patients in the CWCPC and MPCPC groups was 64.4 ± 16.4 and 64.0 ± 17.2 years, respectively. Most patients were male (56.5%), and 48.5% were White. Primary open-angle glaucoma was the most common glaucoma diagnosis (40.4%), 58.5% of the patients had severe glaucoma. Mean preoperative IOP and number of medications were 29.8 ± 10.6 mmHg and 3.7 ± 1.3, respectively. The failure rates at 6 months (46.9% vs. 18.5%) and 1 year (61.5% vs. 40.8%) were higher in MPCPC group (p = 0.001). Mean IOP reduction was slightly greater in the CWCPC group (15.1 ± 13.9 mmHg vs. 14.2 ± 10.4, p = 0.5). Lower laser energy (HR:0.995) and MPCPC (HR:1.698) were associated with higher risk of failure (p = 0.002). The complication rate was higher in the CWCPC group (13.8% vs. 4.6%, p < 0.001); vision loss occurred more in the CWCPC group (4.6% vs. 2.3%), and the only phthisis bulbi occurred in one of the eyes of CWCPC group.
Conclusion
CWCPC was more effective in lowering the IOP despite delivering less total energy than MPCPC but had a higher rate of complications.
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