Take-home: MicroPulse transscleral cyclophotocoagulation is an effective, affordable and safe technique to lower IOP in patients with glaucoma.
Like most hypotensive medications that patients are commonly prescribed, cycloablation was first introduced to reduce IOP by decreasing the production of aqueous humour via the destruction of the ciliary epithelium.
Over time, this treatment has evolved to transscleral cyclophotocoagulation (TSCPC) using a diode laser, which was found to produce the most targeted destruction in the ciliary epithelium.1
While traditional TSCPC is effective at lowering IOP, it has also caused occasional cases of hypotony, phthisis and macular oedema. In a recent literature review, the incidence of hypotony (including phthisis) was found to be as high as 10%.2
While initially applied primarily to patients with recalcitrant glaucoma and few treatment options, TSCPC has gained in popularity in recent years. Studies show that TSCPC patients had final IOP results on par with tube and trabeculectomy patients, with fewer patients losing two or more lines of vision.3,4
TSCPC was found to be more effective than medical therapy at lowering IOP.5