Micro-pulse Transscleral Laser Therapy and ‘Topical-plus’ Anaesthesia: Ideal for Glaucoma Management During COVID-19

ABSTRACT

Micro-pulse transscleral laser therapy (MP-TLT) is a non-invasive laser procedure for the treatment of glaucoma, and was introduced in 2015. The aim of the procedure is to achieve a reduction in intraocular pressure while minimizing collateral tissue damage. The favourable risk profile of this non-cyclodestructive procedure makes it applicable to a broad spectrum of glaucoma cases, including patients with good central vision, and does not limit its usability to late-stage refractive cases. In 2019, a revised delivery device simplified the procedure, and more recently, a ‘topical-plus’ anaesthesia protocol has been introduced. The revised delivery system and topical-plus protocol reinforce the utility of MP-TLT as a practical treatment option in an office setting or procedure room, with minimal patient discomfort during and after treatment. Additionally, with minimal follow-up requirements, MP-TLT is ideal for glaucoma management during COVID-19 social restrictions. The following article provides an overview of the use of MP-TLT under topical anaesthesia (topicalplus), the potential role of MP-TLT in the glaucoma treatment algorithm during the COVID-19 pandemic, and the advantages of the revised MicroPulse P3® probe (IRIDEX Corporation, Mountain View, CA, USA).