Micropulse Transscleral Laser Therapy effective for silicone oil-induced glaucoma

New research found that Micro pulse transscleral laser therapy (MP-TLT) is successful in reducing the Intraocular pressure (IOP) in uncontrolled silicone oil–induced glaucoma (SOG). The study was published in the Journal of Glaucoma.  

Silicone oil has been used as an adjunct for internal tamponade in the management of complicated retinal detachment which is leading to the development of secondary glaucoma called silicone oil-induced glaucoma. Micropulse transscleral laser therapy is a non-invasive laser procedure that is used to reduce intraocular pressure in glaucoma. Researchers from Tunisia studied a prospective case series of 33 eyes to assess the efficiency and safety of MP-TLT in the management of SOG. 

Participants with uncontrolled SOG were enrolled at the Department of Ophthalmology of Mohamed Taher Maamouri Hospital, Nabeul, Tunisia, and were treated with MP-TLT using the IRIDEX Cyclo G6 Glaucoma Laser System with the MicroPulse P3 fiberoptic handheld probe. They also underwent a complete ophthalmologic examination during the 12-month follow-up period.  

Results:

• 33 eyes of 33 patients with SOG were included in the study with a mean age was 50.39 years old.
• Out of these, Silicone oil tamponade was indicated for complicated rhegmatogenous retinal detachment in 22 cases, diabetic tractional retinal detachment in 10 cases, and posttraumatic retinal detachment in 1 case.
• Silicone oil was already removed before the procedure in 23 eyes.
• Silicone oil tamponade duration varied between 3 and 26 months.
• Intraocular pressure (IOP) measurements at enrollment; days 1, 7, and 15; and months 1, 3, 6, and 12 were respectively 37.94±13.61, 19.03±10.98, 16.5±6.17, 19.45±9.73, 19.27±8.33, 19.39±9.52, 19.97±10.03, and 19.7±9.58 mm Hg.
• IOP lowering was 45.38% at 6 months and 45% at 12 months.
• There was a 93.93% of success rate at 6 months and remained stable at 12 months.
• There was no phthisis bulbi nor prolonged inflammation or any other type of major side effects observed.
• No difference was noticed in IOP lowering between patients with silicone oil or those after silicone oil removal (P=0.99). 

Thus, the researchers concluded that MP-TLT was safe and effectively lowered IOP in uncontrolled SOG.

For further reading, click here: 10.1097/IJG.0000000000002051 

Zbiba W, Sayadi S, Kharrat M, Daoued M. Efficacy and Safety of Micropulse Transscleral Laser Therapy in Silicone Oil-induced Glaucoma. J Glaucoma. 2022;31(8):689-693.