Micropulse Transscleral Diode Laser Cyclophotocoagulation (MP-TSCPC) as a Treatment Modality for Glaucoma Patients

Evaluation of the efficacy and safety of a new form of transscleral cyclophotocoagulation (TSCPC) using micropulse diode laser treatment in patients with various types of glaucoma.

In this study, 810 nm infrared diode laser radiation in the micro- pulse mode was used in conjunction with a G probe (IRIDEX Medical Instruments, Mountain View, CA, USA).

The laser settings ranged from 2000- 2500 mW of 810 nm infrared diode laser set on micro- pulse mode, delivered over 100-200 seconds (envelope of micropulses) depending on severity of the case and other patient factors. With duty cycle 31.3% (This translates to 0.5 ms "on" time and 1.1 ms "off" time), which allows the tissue to cool down between laser shots, thus greatly reducing thermal damage.

Inclusion criteria

• Patients previously diagnosed with glaucoma if they had uncontrolled Intraocular pressure despite maximal tolerated medical therapy.
• Patients who are unable to maintain compliance with the prescribed topical medications.
• Patients who need filtering glaucoma surgery for controlling Intraocular pressure but are not generally fit for the surgery.
• Patients who refused incisional procedures like subscleral trabeculectomy.

Exclusion criteria

• Patients who were unable to give informed consent.
• Patients who had undergone previous conventional transscleral diode laser cyclophotocoagulation (TSCPC).
• Patients with significant scleral thinning defined as thinning of more than one clock hour noticed on scleral transillumination.
• Patients with ongoing ocular infection or inflammation.