title: Micropulse versus continuous wave transscleral diode cyclophotocoagulation in refractory glaucoma: a randomized exploratory study.
abstract: BACKGROUND
  The aim of this study was to compare the efficacy and safety of micropulse and continuous wave diode transscleral cyclophotocoagulation in refractory glaucoma.
  
  
  METHODS
  Randomized, comparative, exploratory study in a tertiary hospital setting.
  
  
  METHODS
  Patients with refractory, end-stage glaucoma.
  
  
  METHODS
  Forty-eight patients were randomized to either treatment. The intraocular pressure, visual acuity, number of medicines and repeat treatment were monitored for 18 months. Complications that include visual acuity decline, prolonged anterior chamber inflammation, phthisis bulbi, scleral thinning and ocular pain were noted.
  
  
  METHODS
  Intraocular pressure between 6 and 21 mmHg and at least a 30% reduction with or without anti-glaucoma medications after 18 months.
  
  
  RESULTS
  A successful primary outcome was achieved in 75% of patients who underwent micropulse cyclophotocoagulation and 29% of patients who received continuous wave cyclophotocoagulation after 12 months (P < 0.01). At 18 months, successful outcome was 52% and 30% (P = 0.13), respectively. The mean intraocular pressure was reduced by 45% in both groups (P = 0.70) from a baseline of 36.5 mmHg and 35.0 mmHg (P = 0.50) after 17.5 ± 1.6 months (range 16-19) follow up. No significant difference in retreatment rates or number of intraocular pressure lowering medications was noted. The ocular complication rate was higher in continuous wave treated eyes (P = 0.01).
  
  
  CONCLUSIONS
  Diode transscleral cyclophotocoagulation in both micropulse and continuous modes was effective in lowering intraocular pressure. The micropulse mode provided a more consistent and predictable effect in lowering intraocular pressure with minimal ocular complications.
authors.affiliation: Department of Ophthalmology, National University Hospital, National University Health System, Singapore.
authors.forename: Maria Cecilia D
authors.initials: MC
authors.lastname: Aquino
authors.forename: Keith
authors.initials: K
authors.lastname: Barton
authors.forename: Anna Marie W T
authors.initials: AM
authors.lastname: Tan
authors.forename: Chelvin
authors.initials: C
authors.lastname: Sng
authors.forename: Xiang
authors.initials: X
authors.lastname: Li
authors.forename: Seng Chee
authors.initials: SC
authors.lastname: Loon
authors.forename: Paul T K
authors.initials: PT
authors.lastname: Chew
mesh_terms: D000368:Aged; D002924:Ciliary Body / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D017075:Laser Coagulation / Q000379:methods*; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012590:Sclera; D062606:Tertiary Care Centers; D014065:Tonometry, Ocular; D014792:Visual Acuity / Q000502:physiology
keywords: ciliary body; glaucoma; laser surgery