Revised transscleral laser therapy probe lowers IOP, maintains safety profile of original
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MONTEREY, Calif. — MicroPulse transscleral laser therapy delivered with a functionally and ergonomically revised probe resulted in a greater IOP-lowering effect while maintaining the safety profile of the original, according to a poster.
“We were comparing the original probe vs. the revised probe for MicroPulse transscleral laser therapy, and we found better IOP-lowering effect with the revised probe compared to the original probe,“ Maya Ramachandran, BA, told Healio/OSN at the Women in Ophthalmology Summer Symposium, where the WIO-Top Glaucoma Poster was presented.
Working with Jella An, MD, MBA, Ramachandran and colleagues from the University of Missouri School of Medicine retrospectively reviewed charts of 122 glaucomatous eyes treated by An with the laser therapy over the prior 12 months: 95 with the original MicroPulse P3 probe (Iridex) and 27 with the revised probe, which was released in 2019.
At 12 months, mean IOP was 17.9 mm Hg, a 19% reduction, for the original probe compared with 14.8 mm Hg, a 29.7% reduction, for the revised probe (P = .017). Mean baseline IOP was similar between the two groups, at 23 mm Hg for the original probe group and 22.6 mm Hg for the revised probe group, according to the poster.
Energy delivery is more efficient with the new probe, according to An.
“The newer probe is recessed so it doesn’t protrude out, and it also has a dimple on the foot of the probe that retains the coupling agent better, so there’s always something that couples that increases the energy delivery to the ciliary body,” An told Healio/OSN.
In the study, the settings of power and duration for the original probe were set to deliver total energy of 113.6 J and fluence of 63.7 J/cm2; the revised probe delivered total energy of 79.8 J and fluence of 156.7 J/cm2.
Except for a significantly higher proportion of patients with advanced glaucoma in the revised probe group (P < .001), other baseline demographics were similar between the groups.
“It was interesting that there were more patients with advanced glaucoma who underwent the procedure with the revised probe, and they still had a better IOP-lowering effect with the revised probe compared with the original probe,” Ramachandran said.
If those patients had been more evenly distributed between the groups, the outcomes might have been even more favorable for the revised probe, she said.
Safety was similarly maintained in both groups, in that 26.3% of eyes treated with original probe vs. 18.5% of eyes treated with the revised probe underwent an incisional glaucoma surgery before 12 months, and no adverse events occurred in either group, according to the poster.
“It’s also interesting that more patients who underwent the procedure with the original probe had to undergo an additional glaucoma procedure that was invasive and incisional compared to the revised probe,” Ramachandran said.
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Ramachandran M, et al. Outcomes of MicroPulse transscleral laser therapy using the revised MicroPulse P3 delivery device. Presented at: Women in Ophthalmology Summer Symposium; Aug. 25-28, 2022; Monterey, California (hybrid meeting).
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