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    Cyclophotocoagulation device can help lower IOP

    Consider glaucoma severity, eye pigmentation, medication use

    Take-home message: Consider factors such as glaucoma severity, eye pigmentation, and medication use when selecting power settings for the MicroPulse P3 device.



    Though technology (MicroPulse P3 Glaucoma Device, Iridex) allows surgeons to personalize glaucoma therapy and reduce IOP, there are ways to work the laser effectively depending on several patient factors, said Nathan Radcliffe, MD.

    The MicroPulse P3 is used in conjunction with the CYCLO G6 Glaucoma Laser System in the office or the operating room. This cyclophotocoagulation device controls thermal elevation by chopping a continuous-wave beam into repetitive microsecond pulses (micropulses), which allow the tissue to cool between pulses, Dr. Radcliffe said.

    The treatment is efficient, non-incisional, repeatable, titratable, and can help address common concerns about medication compliance.

    “The laser itself is powerful enough to cause side effects and risks and powerful enough to induce profound IOP lowering,” said Dr. Radcliffe, glaucoma surgeon, New York Eye Surgery Center, New York. “That’s where personalizing and appropriately titrating it comes into play.”

    With use of the MicroPulse, the mean IOP reduced from 38.1 mm Hg to 23.2 mm Hg in a study reported at the American Glaucoma Society meeting in 2015 from Marlene Moster, MD, Philadelphia, according to Dr. Radcliffe. That same study found that the mean number of medications used dropped from 2.54 to 1.77.

    A 2014 study reported a 45% reduction in IOP with use of the P3 and a 75% success rate at 12 months, with no cases of hypotony.1

    With the 200 cases that Dr. Radcliffe has treated, there has been a 30% to 80% reduction in IOP with no cystoid macular edema or phthisis. There has been one case of worsening cataract. Postoperative inflammation can occur and mydriatic pupil has also been reported.

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