Evidence-Based Consensus Guidelines Series for MicroPulse Transscleral Laser Therapy: Dosimetry and Patient Selection
Open Access
- 1 June 2022
- journal article
- research article
- Published by Taylor & Francis Ltd in Clinical Ophthalmology
- Vol. ume 16, 1837-1846
- https://doi.org/10.2147/opth.s365647
Abstract
Purpose: To provide consensus-based current guidelines on optimal dosimetry and patient selection for MicroPulse Transscleral Laser Therapy (TLT) based on a review of the literature and a Delphi method. Methods: A comprehensive search of Pub Med led to the identification and analysis of 61 studies on MicroPulse TLT that contained information on laser settings and patient selection. To determine consensus in areas where there was not enough available literature, a three-round Delphi method was conducted. Results: The response rate was 90% in the first round, 90% in the second round, and 80% in the third round of the Delphi technique. Once all responses were aggregated, a live meeting was held with 80% attendance, and consensus was achieved on each of the findings detailed in this manuscript. Conclusion: Micropulse TLT is a useful addition to the glaucoma armamentarium. When used with proper surgical technique at energy settings within the boundaries described in this manuscript, MicroPulse TLT is a safe and effective treatment for many types and stages of glaucoma. Based on current knowledge and experience, the consensus recommendation of this expert panel is that the standard MicroPulse TLT settings using the revised MicroPulse P3 Probe should be 2500 mW, 31.3% duty cycle, and 4 sweeps at a sweep velocity of 20 seconds each per hemisphere. Both hemispheres avoiding the 3 and 9 clock hours should be treated. The panel also reached consensus on patient selection for MicroPulse TLT providing guidance for the use of the procedure.This publication has 28 references indexed in Scilit:
- Outcomes of Micropulse Transscleral Cyclophotocoagulation in Uncontrolled Glaucoma PatientsJournal of Glaucoma, 2019
- Micropulse Transscleral CyclophotocoagulationOphthalmology Glaucoma, 2019
- Eficacia y seguridad de la ciclofotocoagulación transescleral con micropulsos en el tratamiento del glaucomaArchivos de la Sociedad Española de Oftalmología, 2018
- Patient Outcomes Following Micropulse Transscleral Cyclophotocoagulation: Intermediate-term ResultsJournal of Glaucoma, 2018
- Clinical Efficacy and Safety Profile of Micropulse Transscleral Cyclophotocoagulation in Refractory GlaucomaJournal of Glaucoma, 2018
- Outcome of Micropulse Laser Transscleral Cyclophotocoagulation on Pediatric Versus Adult Glaucoma PatientsJournal of Glaucoma, 2017
- Micropulse Cyclophotocoagulation: Initial Results in Refractory GlaucomaJournal of Glaucoma, 2017
- Micropulse versus continuous wave transscleral diode cyclophotocoagulation in refractory glaucoma: a randomized exploratory studyClinical & Experimental Ophthalmology, 2014
- Micropulse transscleral diode laser cyclophotocoagulation in the treatment of refractory glaucomaClinical & Experimental Ophthalmology, 2010
- Is there any difference in the photobiological properties of melanins isolated from human blue and brown eyes?British Journal of Ophthalmology, 1987