MicroPulse not just for end-stage glaucoma patients
A surgeon shares two cases in which MicroPulse transscleral cyclophotocoagulation was used in younger patients.
Traditional diode transscleral cyclophotocoagulation has been deeply ingrained as a procedure intended for patients with severe end-stage glaucoma and poor vision.
However, I have become increasingly comfortable using MicroPulse (Iridex) transscleral cyclophotocoagulation (MP-TSCPC) in earlier-stage glaucoma and in patients with good vision, including patients who have not had prior incisional glaucoma surgery. I have also found that is has been a useful option in patients with contraindications to more invasive surgery or who want to defer surgery for various reasons. Patients who have already undergone a tube shunt are also good candidates as they do not have many other treatment options available for further IOP control. MicroPulse provides an efficient and effective alternative to glaucoma surgery and can be repeated if necessary.
Because of the high safety profile, combined with the minimal postoperative pain and inflammation I have seen after MicroPulse, I feel confident enough to perform bilateral procedures in a single visit. With a standard post-cataract dose of steroid, I have found that the majority of my patients have little to no anterior chamber inflammation 1 week postoperatively.