Analysis of the therapeutic effect and influencing factors of micropulse laser trabeculopasty in glaucoma patients

Objective To observe the therapeutic effect and influencing factors of micropulse laser trabeculopasty (MLT) in glaucoma patients. Method Retrospective case study.From June 2023 to June 2024, 26 patients (26 eyes) with glaucoma who received MLT treatment at the Ophthalmology Department of Xi'an People's Hospital (Xi'an Fourth Hospital) included 7 patients with uncontrolled intraocular pressure after glaucoma filtration surgery, 2 patients after Ahmed valve implantation, 7 patients with primary glaucoma, 5 patients with secondary glaucoma, and 5 patients with neovascular glaucoma.Observe the degree of intraocular pressure reduction before and after the surgery, the quantity of intraocular fluid used for intraocular pressure reduction before and after the surgery, and postoperative complications (cystoid macular edema, low intraocular pressure, uveitis reaction); and conduct at least 6-month follow-up.Through statistical analysis, the factors influencing the surgical outcome were identified.The main indicators included: gender, age, previous surgical methods, diagnosis, and lens condition. Result A total of 26 patients (26 eyes) were included. The average age was 49.5 ± 12.3 years. Among them, 7 patients had uncontrolled intraocular pressure after glaucoma filtration surgery, 2 patients had Ahmed drainage valve implantation surgery, 7 patients had primary glaucoma, 5 patients had secondary glaucoma, and 5 patients had neovascular glaucoma.The average preoperative intraocular pressure was 41.5 ± 11.1 mmHg. The average intraocular pressure after the operation decreased to 20.3 ± 10.7, 25.0 ± 11.0, 24.2 ± 11.7 and 24.9 ± 11.5 mmHg at 1 week, 1 month, 3 months and 6 months, respectively.The average number of intraocular pressure-lowering drugs used before the operation was 3.2 ± 0.4. The average number of intraocular pressure-lowering drugs at 1 week, 1 month, 3 months, and 6 months after the operation was 2.4 ± 1.1, 2.1 ± 1.2, 2.0 ± 1.2, and 2.2 ± 1.0, respectively.Complications after the surgery included low intraocular pressure (n = 1), uveitis reaction (n = 1), dilated pupil, and conjunctival bleeding, all of which were reversible after treatment. In the multivariate model, neovascular glaucoma and surgical failure were significantly correlated. Conclusion MLT is a safe and effective method for lowering intraocular pressure, and it can also reduce the dosage of eye pressure-lowering medications.For patients who have failed corneal incision glaucoma surgery or those with a high risk of incision-related surgery, MP-TSCPC can also serve as a very good alternative treatment option.