Terapia láser transescleral de micropulsos en el manejo de los pacientes de glaucoma / MicroPulse® transscleral laser therapy in the management of glaucoma patients

Objetivo Evaluar la eficacia y seguridad de la terapia láser transescleral MicroPulse® (TLT) en el tratamiento de pacientes con glaucoma. Métodos Se llevó a cabo una serie de casos prospectiva, intervencionista y no comparativa en el Servicio de Oftalmología del Hospital Universitario Ain Shams en 61 ojos de 46 pacientes con diversos tipos de glaucoma y de gravedad, de leves a graves. Además de la agudeza visual mejor corregida, se registraron la presión intraocular (PIO) y el número de medicamentos para el glaucoma antes y después del tratamiento, junto con la necesidad postoperatoria de inhibidores sistémicos de la anhidrasa carbónica, las tasas de éxito, el número de sesiones de tratamiento y las complicaciones postoperatorias. El éxito se definió como una PIO de 6-18mmHg o una disminución de al menos el 30% de la PIO preoperatoria en ausencia de complicaciones que amenazaran la visión durante el periodo de seguimiento de 6 meses. Resultados Se realizó la TLT MicroPulse® en 61 ojos glaucomatosos. Se repitió la sesión de TLT MicroPulse® en 11 de los 61 ojos (18%) que no alcanzaron una PIO entre 6 y 18mmHg, o una disminución de al menos el 30% con respecto al valor inicial a los 6 meses. A los 6 meses de seguimiento tras una única sesión de TLT MicroPulse® la reducción media de la PIO fue del 35,9%±14,2%, y 6 meses después de la segunda sesión fue del 36,2%±17,5% (p<0,001). La tasa de éxito tras la primera sesión fue del 73,8%, que aumentó al 78,7% tras la segunda sesión. La reacción celular media de la cámara anterior fue de+1,9±0,8 al primer día,+1,0±0,7 a la primera semana y+0,2±0,4 al primer mes del postoperatorio. No se detectaron células en ninguno de los casos a los 3 y 6 meses de seguimiento (p<0,001). El número medio de colirios antiglaucomatosos antes del TLT MicroPulse® fue de 2,6±1,0 (AU)

Objective To evaluate the efficacy and safety of MicroPulse® transscleral laser therapy (TLT) in the management of glaucoma patients. Methods A prospective, interventional, non-comparative case series was conducted in the department of ophthalmology, Ain Shams University Hospital on 61 eyes of 46 patients with various glaucoma types and of severity, ranging from mild to severe. In addition to best-corrected visual acuity (BCVA), intraocular pressure (IOP) and the number of glaucoma medications were recorded before and after treatment, along with the postoperative need for systemic carbonic anhydrase inhibitors (CAI), success rates, number of treatment sessions and postoperative complications. Success was defined as an IOP of 6-18mmHg or at least a 30% decrease from preoperative IOP in the absence of any vision-threatening complications during the 6-month follow-up period. Results MicroPulse TLT was performed on 61 glaucomatous eyes. Eleven of the 61 eyes (18%) that did not achieve IOP between 6-18mmHg, or at least a 30% decrease from baseline at 6 months, had a repeat MicroPulse TLT session. At 6 months follow-up post a single MicroPulse TLT session, the mean IOP reduction was 35.9±14.2%; and 6 months after the second session, it was 36.2±17.5% (P<.001). The success rate after the first session was 73.8% which increased to 78.7% after the second session. The mean anterior chamber (AC) cell reaction was+1.9±.8 at 1 day,+1.0±.7 at 1 week, and+.2±.4 at 1 month postoperatively. No cells were detected in any of the cases at 3 and 6 months follow-up (P<.001). The average number of anti-glaucoma eye drops before MicroPulse TLT was 2.6±1.0. Postintervention, the average number of anti-glaucoma eye drops was 1.7±1.2, and sustained at 6 months follow-up after the last treatment session (P<.001). There were no significant complications were noted. One eye developed transient hypotony for 3 months after MicroPulse TLT (AU)

MicroPulse® transscleral laser therapy in the management of glaucoma patients.

PURPOSE: To evaluate the efficacy and safety of MicroPulse® transscleral laser therapy (TLT) in the management of glaucoma patients. METHODS: A prospective, interventional, non-comparative case series was conducted in the department of ophthalmology, Ain Shams University Hospital on 61 eyes of 46 patients with various glaucoma types and of severity, ranging from mild to severe. In addition to best-corrected visual acuity (BCVA), intraocular pressure (IOP) and the number of glaucoma medications were recorded before and after treatment, along with the postoperative need for systemic carbonic anhydrase inhibitors (CAI), success rates, number of treatment sessions and postoperative complications. Success was defined as an IOP of 6-18 mmHg or at least a 30% decrease from preoperative IOP in the absence of any vision-threatening complications during the 6-month follow-up period. RESULTS: MicroPulse TLT was performed on 61 glaucomatous eyes. Eleven of the 61 eyes (18%) that did not achieve IOP between 6-18 mmHg, or at least a 30% decrease from baseline at 6 months, had a repeat MicroPulse TLT session. At 6 months follow-up post a single MicroPulse TLT session, the mean IOP reduction was 35.9 ± 14.2%; and 6 months after the second session, it was 36.2 ± 17.5% (p < 0.001). The success rate after the first session was 73.8% which increased to 78.7% after the second session. The mean anterior chamber (AC) cell reaction was +1.9 ± 0.8 at 1 day, +1.0 ± 0.7 at 1 week, and +0.2 ± 0.4 at 1 month postoperatively. No cells were detected in any of the cases at 3 and 6 months follow-up (p < 0.001). The average number of anti-glaucoma eye drops before MicroPulse TLT was 2.6 ± 1.0. Postintervention, the average number of anti-glaucoma eye drops was 1.7 ± 1.2, and sustained at 6 months follow-up after the last treatment session (p < 0.001). There were no significant complications were noted. One eye developed transient hypotony for 3 months after MicroPulse TLT. CONCLUSIONS: MicroPulse TLT is safe and effective in lowering IOP in a variety of glaucoma types and severity.