Efficacy and safety of micropulse transcleral cyclophotocoagulation using the original and revised pars plana probe

PURPOSE: To compare the efficacy and safety of micropulse transcleral cyclophotocoagulation (MP-TSCPC) using the original and revised pars plana probe in patients with glaucoma. METHODS: Retrospective review of records who underwent MP-TSCPC between August 2020 and July 2023. Patients aged >12 years and with a minimum follow-up of 1 year were included. Success was defined as intraocular pressure (IOP) ≥ 6 and ≤21 mm Hg with the same or fewer antiglaucoma medications and a minimum of 20% IOP reduction. RESULTS: A total of 21 eyes treated with the original probe and 22 eyes treated with the revised probe were included. Baseline characteristics were comparable between the two groups. Mean IOP reduced from 30.3 ± 9.9 mm Hg to 21.8 ± 8.2 and 20.2 ± 7.5 ( P < 0.001) mm Hg at 6 months and 1 year, respectively, with the original probe and from 26.1 ± 8.4 mm Hg to 19.1 ± 7.4 and 18.8 ± 5.8 ( P = 0.009) mm Hg at 6 months and 1 year, respectively, with the revised probe. The difference between the probes was not statistically significant at all-time points. The mean number of antiglaucoma medications reduced from 3.9 ± 0.7 to 3.3 ± 1 at 1 year ( P = 0.006) with the original probe and from 3.9 ± 1.1 to 3.4 ± 1.4 at 1 year ( P = 0.045) with the revised probe. The probability of qualified success at 1 year was 33.3% for the original probe and 40.9% for the revised probe ( P = 0.755). CONCLUSION: MP-TSCPC is a safe and effective treatment for reducing IOP with both the original and revised probes, but the efficacy is not long-lasting.