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

Tomas M Grippo,1 Marc Töteberg-Harms,2 Michael Giovingo,3 Brian A Francis,4 Ronald RMPC de Crom,5 Brian Jerkins,6 Jacob W Brubaker,7 Jella An,8 Nathan Radcliffe,9 Robert Noecker10 1Grippo Glaucoma and Cataract Center, Buenos Aires, Argentina; 2Department of Ophthalmology, Medical College of Georgia, Augusta University, Augusta, GA, USA; 3Cook County Health, Chicago, IL, USA; 4Department of Ophthalmology, Doheny and Stein Eye Institutes, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA; 5University Eye Clinic, Maastricht University Medical Centre, Maastricht, the Netherlands; 6Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN, USA; 7Sacramento Eye Consultants, Sacramento, CA, USA; 8Department of Ophthalmology, Wilmer Eye Institute, John Hopkins School of Medicine, Bethesda, MD, USA; 9Glaucoma Department, New York Eye and Ear Infirmary, New York, NY, USA; 10Ophthalmic Consultants of Connecticut, Fairfield, CT, USACorrespondence: Tomas M Grippo, Grippo Glaucoma and Cataract Center, 250 Luis Maria Campos, 1st Floor, Suite O, Capital Federal, 1426, Argentina, Tel +54-11-4-774-2930, Email tomasgrippo@yahoo.comPurpose: 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