Letter to the Editor: One-Year Outcomes of Micropulse Cyclophototherapy for Primary Open-angle Glaucoma

Precis: In primary open-angle glaucoma (POAG), micropulse trans-scleral cyclophototherapy (MPTCP) is effective in lowering intraocular pressure (IOP), but its effects are not permanent. Hence, it can serve as a temporizing measure before definitive glaucoma surgery. Purpose: There is limited data on MPTCP in POAG. This is the first study that looks at MPTCP treatment specifically in POAG patients. Patients and Methods: This is an interventional, single-institution exploratory case series with 55 eyes of 48 patients with POAG. Data was collected from clinical records, including patient demographics, clinical information, number of glaucoma medications, MPTCP laser settings, complications, and clinical outcomes. Results: Patients had a mean age of 67.3 +/- 14.1 years with a preponderance of males. IOP was 24.8 +/- 1.0 mm Hg before MPTCP and decreased to 19.7 +/- 1.1, 21.9 +/- 1.1, and 21.8 +/- 1.1 mm Hg at postoperative month 3, 6, and 12 respectively. IOP remained below pretreatment levels throughout the postoperative period (P<0.05). Visual acuity and mean deviation remained stable before and after MPTCP. No eyes had complications. Number of glaucoma medications remained the same after MPTCP. Four eyes required additional oral acetazolamide at postoperative month 1 for IOP control. Seventeen eyes subsequently required further surgical intervention after 9.84 months. Maximal IOP decrease was greater when there were higher power settings, higher preoperative IOP, and better preoperative visual acuity. Conclusions and Relevance: The IOP lowering effect of MPTCP treatment in patients with POAG was found to be modest and transient with a similar medication burden, and definitive glaucoma surgery was needed in a number of patients.