Micropulse transscleral laser therapy for glaucoma: a retrospective study

Objective: To evaluate the safety and efficacy of micropulse transscleral laser therapy (MPTLT) in patients with glaucoma at a tertiary eye center in Hong Kong.Methods: Medical records of patients who underwent MPTLT at Hong Kong Eye Hospital between 1 August 2020 and 31 July 2021 were retrospectively reviewed.Successful treatment was defined as a postoperative intraocular pressure (IOP) between 6 and 21 mmHg or a 20% reduction in IOP from baseline, without an increase in glaucoma medications (topical or oral) or additional glaucoma interventions.Results: In total, 205 eyes underwent MPTLT either for the first time (n=100) or retreatment (n=105).The mean preoperative visual acuity was 1.6 LogMAR, and 42 (20.5%)eyes had a baseline visual acuity of light perception or worse.The mean preoperative IOP was 27.7 mmHg.All the patients were on the maximum tolerated medical therapy prior to undergoing MPTLT; the mean number of preoperative topical anti-glaucoma medications was 4.1.The mean energy administered was 116.4 J.The overall success rates were 64.9% at 1 month, 51.7% at 3 months, 42.4% at 6 months, 31.2% at 1 year, and 29.3% at 18 months.Success rates were comparable across all time points for both groups.At 18 months or the last visit before additional intervention, the mean IOP reduced 11.3% to 23.3 mmHg (p<0.001), and approximately 23% of patients had an IOP reduction of at least 20%.The mean number of topical anti-glaucoma medications required decreased 5.3% from 4.1 to 3.9 (p=0.003).The decrease was significant in eyes