Date Posted: June 10, 2026

Author/s: Rudolf Christian F. Palma, MD; Julia Mercedes C. Villalva, MD; Manolito R. Reyes, MD and Alobert Vergel A. Capati, MD

Background: This systematic review and meta-analysis aimed to review available information that addresses the question regarding the long-term efficacy in intraocular pressure (IOP) control and reduction, and the complication rates of Micropulse Transscleral Cyclophotocoagulation in patients with glaucoma.

Methods: CENTRAL, PubMed, and Google Scholar were used as data sources. Studies that included glaucoma patients who underwent MP-TSCPC with a one-year or more postoperative follow-up with data on pre- and postoperative IOP and complications were considered. NHLBI Quality Assessment Tools were used for the included studies. The treatment effect measures were 1) weighted mean difference (WMD) for the IOP reduction and 2) proportions for the complication rate. Outcome measures were reported with a 95% confidence interval (CI), and p < 0.05 was considered statistically significant. Analysis was performed using Microsoft Excel and Open Meta Analyst software.

Results: In this systematic review, a total of 13 studies were included. Ten were case series, two were observational cohorts, and one randomized controlled trial. Risk of bias studies showed low to moderate risk among the included studies. In random effects model, the pooled weighted mean difference was -13.649 (95% CI: [-16.350 – -10.948], p < 0.001) showing statistically significant reduction in IOP after MP-TSCPC. Pooled proportion risk for complications was 0.418 (95% CI: [0.174 – 0.663], p < 0.001). Among the most common complications are post-operative inflammation at 0.257 (95% CI: [0.094 – 0.420], p = 0.002) and post-operative pain at 0.039 (95% CI: [0.017 – 0.061], p < 0.001). I2 statistics showed considerable heterogeneity for IOP reduction (I2 = 94.013%, p < 0.001) and complication rate (I2 = 99.422%, p < 0.001).

Discussion: There is a lack of high-quality evidence on the subject as only one RCT was retrieved. Therefore, present findings are based primarily on case series and non-controlled observational studies. Nevertheless, these results showed that MP-TSCPC has good efficacy in reducing and controlling IOP after a year post-operatively. It is also safe with a low risk of complications, with the more common complications being postoperative inflammation and postoperative pain. However, these results should be interpreted with due caution due to this review’s high heterogeneity and possible publication bias.

Keywords:
Glaucoma, intraocular pressure, complications, micropulse transscleral cyclophotocoagulation, meta-analysis, systematic review