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Arch Soc Esp Oftalmol (Engl Ed) ; 95(7): 327-333, 2020 Jul.
Artículo en Inglés, Español | MEDLINE | ID: mdl-32409244

RESUMEN

OBJECTIVE: To determine the effectiveness and safety of the micropulse transscleral technique in lowering intraocular pressure in patients with glaucoma. MATERIALS AND METHODS: A retrospective cohort study was conducted on 143 eyes with various glaucoma subtypes between October 2016 and December 2018. Patients were grouped for analysis based on glaucoma subtypes, preoperative demographics, previous surgical procedures, and postoperative results. The data collected was based on intra- and post-operative complications, intraocular pressure, visual acuity, the need of micropulse re-treatment, incisional glaucoma surgery, and increasing the dose/quantity of medications. A logistic and Cox regression model was performed to determine predictors of therapeutic failure, in addition to building Kaplan-Meier curves. RESULTS: The mean follow-up was 268 days, and 63% of the patients completed one year. The micropulse procedure achieved a mean intraocular pressure decline of 7.3mmHg (excluding neovascular glaucoma), independent of the glaucoma subtype. The percentage of patients who achieved intraocular pressure less than 20mmHg at 24h was 78%, with 80% at 3 months, 77% at 6 months, and 78% at 12 months. During the follow-up, 29.6% of the patients required additional treatment or a dose increase. Only 2patients presented with minimal postoperative complications. CONCLUSION: The treatment with transscleral micropulse is a safe and efficient technique for use in glaucoma, attaining a reduction in intraocular pressure and decrease in need of antihypertensive medications within the first year following the procedure.


Asunto(s)
Glaucoma/cirugía , Terapia por Láser , Láseres de Semiconductores/uso terapéutico , Anciano , Terapia Combinada , Resistencia a Medicamentos , Femenino , Estudios de Seguimiento , Glaucoma/tratamiento farmacológico , Glaucoma Neovascular/cirugía , Humanos , Estimación de Kaplan-Meier , Terapia por Láser/efectos adversos , Terapia por Láser/métodos , Masculino , Persona de Mediana Edad , Soluciones Oftálmicas/uso terapéutico , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Modelos de Riesgos Proporcionales , Reoperación , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Insuficiencia del Tratamiento , Resultado del Tratamiento
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