Micropulse Transscleral Cyclophotocoagulation in Glaucoma Treatment: A Literature Review

Abstract

Introduction. Glaucoma is a chronic, progressive optic neuropathy that leads to irreversible blindness if left untreated. Slowing disease progression relies on reducing intraocular pressure using medical and surgical approaches. In search of safer and more effective laser cyclodestructive techniques, micropulse transscleral cyclophotocoagulation (MP-TSCPC) was introduced. Methods. A literature review was conducted to evaluate the long-term efficacy and safety of MP-TSCPC using the PubMed, Embase, Web of Science, and Scopus databases. Nineteen publications, between 2010 and 2026, comprising 1 512 eyes after MP-TSCPC, were included. Treatment efficacy and safety were assessed at a follow-up of at least-12 months by analysing intraocular pressure reduction, changes in the number of glaucoma medications, and complication rates. Results. All studies demonstrated a statistically significant reduction in intraocular pressure from one week to 12 months following MP-TSCPC. The mean intraocular pressure reduction at 12 months ranged from 27.1% to 48.6% compared to baseline values. In studies with longer follow-ups, the pressure-lowering effect persisted for up to 36 months. Sixteen of the nineteen studies reported a significant reduction in the number of glaucoma medications. The most frequently reported adverse events were mild and transient with a frequency of up to 40%. Serious complications, including cystoid macular oedema, prolonged hypotony, and phthisis bulbi, were rare. There were no reported cases of endophthalmitis, sympathetic ophthalmia, retinal detachment, or vitreous haemorrhage. Ten of the nineteen studies did not indicate a significant change in postoperative vision. Conclusions. MP-TSCPC is an effective and safe intervention that provides a significant long-term reduction in intraocular pressure and decreases the need for glaucoma medications.