Evidence-Based Consensus Guidelines Series for MicroPulse Transscleral Laser Therapy - Surgical Technique, Post-Operative Care, Expected Outcomes and Retreatment/Enhancements

Abstract

Purpose

To provide expert consensus and evidence-based current guidelines on treatment technique, postoperative care, expected outcomes and retreatment for MicroPulse Transscleral Laser Treatment (TLT).

Methods

A comprehensive search of PubMed led to the identification and analysis of 61 studies on MicroPulse TLT. To provide guidance in areas where there was not enough available literature, a three-round Delphi method was conducted involving 10 international experts in MicroPulse TLT.

Results

The response rate was 70% in the first round, 70% in the second round, and 80% in the third round of the Delphi method. Once all responses were aggregated, a live meeting was held with 90% attendance, and consensus was achieved on each of the findings detailed in this manuscript.

Conclusion

Used within appropriate treatment parameters, with proper technique and patient selection, MicroPulse TLT is a safe and effective treatment for many types and severities of glaucoma. MicroPulse TLT represents a useful addition to the glaucoma armamentarium.

Keywords:

• glaucoma
• MicroPulse
• transscleral laser treatment

Ethics Approval

This paper did not require any original research, and thus, no ethics approval was needed.

Consent to Publication

Brian Jerkins consents to have the image of the MicroPulse P3 Probe on the limbus published.

Acknowledgments

Writing and editing support was provided by Adrianne Resek, MA. Ms. Resek participated in the development and analysis of the Delphi method questionnaires in addition to preparation of the manuscript. Paul Chew, MD, and Ziad Khoueir, MD, reviewed this manuscript and provided comments.

Disclosure

The following authors have received grant support (S), lecture fees (L), or consulting fees (C) from Iridex Corporation: Jella An (S, L); Jacob W Brubaker (S, L); Ronald MPC de Crom (S, L); Brian A Francis (S, L); Michael Giovingo (S, L); Tomas M Grippo (C, S, L); Brian Jerkins (S); Robert Noecker (C, S, L); Nathan Radcliffe (S); Marc Toeteberg-Harms (S, L). Prof. Dr. Marc Töteberg-Harms also reports speaker’s honorarium from Allergan, MLase AG, ELIOS, ELT Sight, Novartis/Alcon, Santen, Heidelberg Engineering, and Glaukos; honorarium for Advisory Board Activity from Reichert, outside the submitted work. Dr Michael Giovingo also reports grants from Santen, outside the submitted work. Dr Jella An also reports personal fees from Alcon, New World Medical, Aerie, Sight Sciences; grants from Abbvie, outside the submitted work. Dr Nathan Radcliffe also reports personal fees from Alderya, Avellino, Aerie Pharmaceuticals; Alcon Vision, Alimera Sciences, Allergan/AbbVie, Bausch + Lomb, Beaver-Visitec International, Belkin, CATS, Carl Zeiss Meditec, CATS, Dompe, Ellex, ELIOS Vision Inc, Equinox, Eyepoint Pharmaceuticals, Glaukos, Iridex, IrisVision, Kala Pharmaceuticals, Lumenis, New World Medical, Novartis, Ocular Science, Ocular Therapeutix, Omeros, Reichert, Santen, Shire, Sight Sciences, Spyglass, Tarsus, Thea, TearClear and ViaLase, outside the submitted work. The authors report no other conflicts of interest in this work.

Additional information

Funding

Funding for research on this paper was provided by Iridex Corporation. Funding for writing support for this paper was provided by Iridex Corporation to Adrianne Resek, MA. Iridex was not privy to questionnaires, responses or data collection during the Delphi Consensus process nor were they privy to the manuscript during its preparation, writing and submission.