Efficiency of micropulse cyclophotocoagulation in treatment of refractory glaucoma

    Purpose. To evaluate the clinical efficacy of micropulse cyclophotocoagulation (mCPC) in the treatment of patients with grade III refractory glaucoma.

    Material and methods. A clinical analysis of the state of 30 eyes with grade III refractory glaucoma after mCPC was performed. Forms of glaucoma: multiple operated primary open-angle glaucoma – 22 eyes, neovascular glaucoma – 7 eyes, uveal glaucoma with neovascularization – 1 eye. The level of intraocular pressure (IOP) before surgery was 27–41 mm Hg, averaging 32.2 ± 3.8 mm Hg. The average number of antihypertensive drops before surgery was 2.6 ± 0.3 drugs. The observation period was 6 months.

    Results. All surgeries went without complications. The average level of IOP on the 1st postoperative day was 22.7 ± 2.1 mm Hg, in 93 % of cases IOP decreased to 18–24 mm Hg.

    After 1 week, the average level of IOP was 21.8 ± 1.7 mm Hg: in 93 % of cases it was 18–23 mm Hg, in 7 % the level of IOP remained elevated to 25–27 mm Hg. Art. By the 1st month after mCPC, the average IOP level decreased to 20.3 ± 2.2 mm Hg, after 3 months it was 20.8 ± 2.2 mm Hg. After 6 months, the level of IOP corresponded to 18–26 mm Hg. Art., averaging 21.6 ± 1.9 mm Hg. The number of antihypertensive drugs was reduced to an average of 1.7 ± 0.2.

    Conclusion. mCPC has been shown to be effective in normalizing IOP levels in the majority of patients with grade III refractory glaucoma (87 %) at 6 month follow-up.

    Keywords: refractory glaucoma, micropulse cyclophotocoagulation, intraocular pressure.