Evidence-Based Consensus Guidelines Series for MicroPulse Transscleral Laser Therapy - Surgical Technique, Post-Operative Care, Expected Outcomes and Retreatment/Enhancements

Tomas M Grippo; Marc Töteberg-Harms; Michael Giovingo; Brian A Francis; Ronald R M P C de Crom; Brian Jerkins; Jacob W Brubaker; Jella An; Nathan Radcliffe; Robert Noecker

doi:10.2147/OPTH.S389198

Evidence-Based Consensus Guidelines Series for MicroPulse Transscleral Laser Therapy - Surgical Technique, Post-Operative Care, Expected Outcomes and Retreatment/Enhancements

Clin Ophthalmol. 2023 Jan 6:17:71-83. doi: 10.2147/OPTH.S389198. eCollection 2023.

Authors

Affiliations

¹ Grippo Glaucoma and Cataract Center, Buenos Aires, Argentina.
² Department of Ophthalmology, Medical College of Georgia, Augusta University, Augusta, GA, USA.
³ Cook County Health, Chicago, IL, USA.
⁴ Department of Ophthalmology, Doheny and Stein Eye Institutes, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA.
⁵ University Eye Clinic, Maastricht University Medical Centre, Maastricht, the Netherlands.
⁶ Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN, USA.
⁷ Sacramento Eye Consultants, Sacramento, CA, USA.
⁸ Department of Ophthalmology, Wilmer Eye Institute, John Hopkins School of Medicine, Bethesda, MD, USA.
⁹ Glaucoma Department, New York Eye and Ear Infirmary, New York, NY, USA.
¹⁰ Ophthalmic Consultants of Connecticut, Fairfield, CT, USA.

Abstract

Purpose: To provide expert consensus and evidence-based current guidelines on treatment technique, postoperative care, expected outcomes and retreatment for MicroPulse Transscleral Laser Treatment (TLT).

Methods: A comprehensive search of PubMed led to the identification and analysis of 61 studies on MicroPulse TLT. To provide guidance in areas where there was not enough available literature, a three-round Delphi method was conducted involving 10 international experts in MicroPulse TLT.

Results: The response rate was 70% in the first round, 70% in the second round, and 80% in the third round of the Delphi method. Once all responses were aggregated, a live meeting was held with 90% attendance, and consensus was achieved on each of the findings detailed in this manuscript.

Conclusion: Used within appropriate treatment parameters, with proper technique and patient selection, MicroPulse TLT is a safe and effective treatment for many types and severities of glaucoma. MicroPulse TLT represents a useful addition to the glaucoma armamentarium.

Keywords: MicroPulse; glaucoma; transscleral laser treatment.

Grants and funding

Funding for research on this paper was provided by Iridex Corporation. Funding for writing support for this paper was provided by Iridex Corporation to Adrianne Resek, MA. Iridex was not privy to questionnaires, responses or data collection during the Delphi Consensus process nor were they privy to the manuscript during its preparation, writing and submission.