Efficacy of micropulse cyclophotocoagulation in acute angle-closure glaucoma

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Abstract

BACKGROUND: An improved technique of cyclophotocoagulation appeared — cyclophotocoagulation in micropulse mode with splitting of the continuous stream of laser energy into short micropulse series with intervals.

AIM: The aim of the study is to clinically evaluate the efficacy and the safety of micropulse cyclophotocoagulation for acute angle-closure glaucoma jugulation.

MATERIALS AND METHODS: In the study, 14 patients with acute angle-closure glaucoma with 3–7 days duration were included. The mean intraocular pressure was 35.1 ± 2.4 mm Hg against the background of hypotensive therapy, best corrected visual acuity was from 0.005 to 0.3. All patients on admission underwent laser iridotomy, consistent peripheral colobomas of the iris were obtained. On the following day, taking into account the intraocular pressure level of 30–36 mm Hg against the background of hypotensive therapy, all patients underwent micropulse cyclophotocoagulation with Cyclo G6® Glaucoma Laser System (USA).

RESULTS: After surgery, there were no complications noted. The pain syndrome was completely eliminated in all patients on the first day after the procedure. Intraocular pressure decreased in average to 18.1 ± 2.8 mm Hg. Within 3–18 months after micropulse cyclophotocoagulation, phacoemulsification was performed in 9 eyes. During the 2 years of the follow-up period, intraocular pressure in all eyes remained normal, from 16 to 23 mm Hg, best-corrected visual acuity varied from 0.4 to 0.9.

CONCLUSIONS: Cyclophotocoagulation in micropulse mode allowed an effective and safe lowering of intraocular pressure to normal values in all eyes with acute angle-closure glaucoma; this provided pain relief and preservation of visual functions during the follow-up period up to 2 years.

About the authors

Oleg V.  Kolenko

S. Fyodorov Eye Microsurgery Federal State Institution, Khabarovsk Branch; Postgraduate Institute for Public Health Workers; Far-Eastern State Medical University

Email: naukakhvmntk@mail.ru
ORCID iD: 0000-0001-7501-5571
SPIN-code: 5775-5480
Scopus Author ID: 6506683725
ResearcherId: AAI-2976-2020

Dr. Sci. (Med.), director of the Khabarovsk Branch; head of the Ophthalmology Chair; professor of the General and Clinical Surgery Chair

Russian Federation, Khabarovsk; Khabarovsk; Khabarovsk

Natalia V. Postupaeva

S. Fyodorov Eye Microsurgery Federal State Institution, Khabarovsk Branch; Postgraduate Institute for Public Health Workers

Author for correspondence.
Email: naukakhvmntk@mail.ru
ORCID iD: 0000-0002-5364-4964
SPIN-code: 4279-5249
Scopus Author ID: 57980134700
ResearcherId: AAK-8765-2021

МD, Cand. Sci. (Med.), ophthalmologist; assistant professor

Russian Federation, Khabarovsk; Khabarovsk

Alexey V. Postupaev

S. Fyodorov Eye Microsurgery Federal State Institution, Khabarovsk Branch

Email: naukakhvmntk@mail.ru
ORCID iD: 0000-0002-8028-9267
SPIN-code: 3290-9709
Scopus Author ID: 57980327300

ophthalmologist

Russian Federation, Khabarovsk

Evgenii L. Sorokin

S. Fyodorov Eye Microsurgery Federal State Institution, Khabarovsk Branch; Far-Eastern State Medical University

Email: naukakhvmntk@mail.ru
ORCID iD: 0000-0002-2028-1140
SPIN-code: 4516-1429
Scopus Author ID: 7006545279
ResearcherId: AAI-2986-2020

Dr. Sci. (Med.), Professor; professor of the General and Clinical Surgery Chair

Russian Federation, Khabarovsk; Khabarovsk

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2. Fig. 1. Clinical cases of acute angle-closure glaucoma: a — a 69-year-old female patient J.; b — a 63-year-old female patient B. On admission: congestive redness of the eyeball vessels, corneal edema, shallow anterior chamber, dilated pupil of irregular shape

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3. Fig. 2. A 69-year-old female patient J. The first day after micropulse cyclophotocoagulation: a — the cornea is transparent, increase in anterior chamber depth; b — redness of the eyeball vessels reduced, subconjunctival hemorrhage after an injection, areas of sector iris atrophy; c — consistent peripheral coloboma of the iris at the 1 o’clock position

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4. Fig. 3. A 63-year-old female patient B. The first day after micropulse cyclophotocoagulation: a — the cornea is transparent, increase in anterior chamber depth, partially ruptured posterior synechiae in the pupil area; b — redness of the eyeball decreased; c — consistent peripheral colobomas of the iris at 10, 1, 7 o’clock positions

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5. Fig. 4. Dynamics of intraocular pressure level after micropulse cyclophotocoagulation during 2 years

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