Micropulse Transscleral Cyclophotocoagulation as Primary Surgical Treatment for Primary Open Angle Glaucoma in Taiwan during the COVID-19 Pandemic

Hsiao-Ling Chang; Shih-Chun Chao; Ming-Tsung Lee; Hung-Yu Lin

doi:10.3390/healthcare9111563

Micropulse Transscleral Cyclophotocoagulation as Primary Surgical Treatment for Primary Open Angle Glaucoma in Taiwan during the COVID-19 Pandemic

Healthcare (Basel). 2021 Nov 17;9(11):1563. doi: 10.3390/healthcare9111563.

Authors

Hsiao-Ling Chang¹, Shih-Chun Chao^{1

2

3}, Ming-Tsung Lee^{4

5}, Hung-Yu Lin^{1

2

6

7}

Affiliations

¹ Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua 500, Taiwan.
² Department of Optometry, Central Taiwan University of Science and Technology, Taichung 406, Taiwan.
³ Department of Optometry, Yuan Pei University, Hsinchu 300, Taiwan.
⁴ Postdoctoral Fellow National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin 632, Taiwan.
⁵ Department of Nursing, Hungkuang University, Taichung 433, Taiwan.
⁶ Department of Optometry, Chung Shan Medical University, Taichung 402, Taiwan.
⁷ Department of Early Childhood and Family Educare, Chung Chou University of Science and Technology, Changhua 510, Taiwan.

Abstract

Glaucoma is the leading cause of irreversible blindness worldwide, with primary open angle glaucoma (POAG) accounting for the greatest number of total glaucoma cases. This study aimed to evaluate the efficacy and safety of micropulse transscleral cyclophotocoagulation (MP-TSCPC) as a primary procedure in POAG during the COVID-19 pandemic. We retrospectively analyzed 60 eyes of 52 patients, who were diagnosed with mild-to-end-stage POAG without previous glaucoma surgery and received MP-TSCPC between 1 January 2020 and 31 August 2020. The mean preoperative intraocular pressure (IOP) significantly decreased from 27.8 mm Hg to 19.8, 20.1, 20.3, 20.4, and 20.2 mm Hg at 1, 3, 6, 9, and 12 months, respectively (all p < 0.05). The mean number of IOP-lowering medications used significantly decreased from 3.3 at the baseline to 1.6, 1.8, 1.8, 1.9, and 1.9 at 1, 3, 6, 9, and 12 months, respectively (all p < 0.001). Total withdrawal of antiglaucoma medications was fulfilled in five patients. The main outcome was achieved in 81.7% at postoperative month 12. The most common adverse effect was transient mydriasis (28.3%). No major complications were encountered. MP-TSCPC seems to be an effective and safe treatment to reduce IOP and the medication burden with minimal vision-threatening complications in mild-to-end-stage POAG patients without previous glaucoma surgery.

Keywords: diode laser; glaucoma; intraocular pressure; micropulse; transscleral cyclophotocoagulation.