Background Primary open-angle glaucoma (POAG) is a leading etiology of irreversible blindness worldwide. Reducing intraocular pressure (IOP) remains the mainstay of management to avoid damage to the optic nerve. Micropulse transscleral cyclophotocoagulation (MP-TSCPC) is a newer, minimally invasive laser technique that delivers energy in pulses, minimizing collateral tissue damage. Its impact on anterior chamber depth (ACD) and macular microcirculation, however, remains under-explored. Purpose To assess changes in anterior chamber depth (ACD) and macular circulation following MP-TSCPC laser treatment in POAG patients. Patients and methods This cross-sectional interventional research has been performed on 30 POAG patients at Suez Canal University Hospital and Egyptian Eye Academy between July 2020 and 2023. Pre- and post-treatment evaluations included IOP measurement, best-corrected visual acuity (BCVA), ACD (Pentacam HR), and macular vascular metrics (swept-source Optical coherence tomography angiography). Laser treatment was performed using the CYCLO G6 system (2000 mW, 90 s/hemisphere, 31.3% duty cycle). Follow-up assessments were performed 2 weeks postoperatively. Results Mean IOP significantly decreased from 23.27±8.18 to 14.73±5.6 mmHg ( P <0.001). No significant alteration has been found in BCVA or ACD. The foveal avascular zone region in superficial and deep layers remained stable. However, macular vascular density significantly decreased in the nasal and inferior sectors ( P =0.013 and 0.008, respectively). Conclusion MP-TSCPC effectively reduces IOP without significantly affecting ACD or visual acuity. Although the foveal avascular zone area remained unchanged, reduced macular vascular density in specific regions suggests a possible localized vascular impact that merits further investigation.
EL-nahass et al. (Thu,) studied this question.