The effect of Micropulse Transcleral Cyclophotocoagulation (MP-TSCPC) on anterior segment properties in glaucoma and ocular hypertension patients

Purpose Micropulse Transcleral Cyclophotocoagulation (MP-TSCPC) lowers intraocular pressure by directing bursts of energy at the ciliary body which leads to a reduction in aqueous production. Although the diode laser radiation has a propensity for melanin in the ciliary epithelium, some energy dissipates into surrounding tissues. This study aims to investigate the ocular effects of MP-TSCPC on patients with glaucoma, focusing on corneal biomechanics, endothelial cell count, and refractive outcomes. Methods Patients with open angle glaucoma and ocular hypertension were enrolled. Comprehensive ophthalmic investigations, including endothelial cell count, corneal topography, pupil diameter, and refraction, were conducted at baseline and six months post-MP-TSCPC. Results Thirty-one eyes of 31 patients were included. At six months post-MP-TSCPC, a 2% decrease in corneal endothelial cell density was noted, though not statistically significant. A statistically significant spherical error change was observed with three patients having a significant hypermetropic shift. There was a significant decrease in mean local thinnest corneal thickness and an increase pupil diameter. Conclusion This is the first study to review various ocular parameters following micropulse transcleral cyclophotocoagulation. Our findings suggest that the procedure may impact the peri-limbal nerve plexus, necessitating caution in high-risk patients. However, overall, there was minimal impact on ocular parameters.