Micro-pulse TSCPC is becoming popular in glaucoma management as it avoids the complications of glaucoma-filtering-surgeries. However, how effective is this procedure and does it provide any long-term benefits ?
Actually yes, it's effective up to the level it can cause hypotony in some reported cases..
take it seriously..
Dear Dr Albeshri, thank you for your comment. With a 180 degree TSCPC how often do you see hypotony? I would also be curious to know the long-term effects of TSCPC. How long does the effect last? Do multiple sessions ultimately have an additive and prolonged effect?
Dear Dr Syed_Shoeb_Ahmad,
We use it in sever cases, it is effective, however repeat is needed, in eyes we practice there is little concern as are at the end stage of disease....
you may reffer to this article:
https://www.ncbi.nlm.nih.gov/m/pubmed/18414112/
"For transscleral CPC (TCP), there is a wide range of success rates reported in the literature, depending on energy settings, follow-up period, and definitions of success. Repeat TCP is often required. Serious complications have included significant vision loss, hypotony, and phthisis. TCP has mostly been performed in very severe forms of glaucoma, in eyes with limited visual potential, or after filtration surgery has failed, although more recently TCP has been used as a primary surgery in eyes with good visual potential."
https://www.ncbi.nlm.nih.gov/m/pubmed/18414112/
I've done a few and find it works surprisingly well. Subconj lidocaine with about 180-270 degrees of treatment. Postop there is quite a bit of flare, but remarkably no pain. Good for eyes with poor visual potential, but also eyes with good VA who are not candidates for a shunt or other surgery. Note that transcleral diode (810) cyclophotocoagulation is continuous wave, not micropulse. It works by destruction of the CB. Trans pars plana micropulse laser is different, ideally non destructive. I have no experience with the trans pars plana micropulse treatment.
I have done some cases of diode laser cyclophotocoagulation. Does not necessarily cause hypotony if you only do180 degrees. Causes a pressure spike at the first 3 days so let your patient continue his antiglaucoma after the procedure. Not necessarily done in very low Visual acuities
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