{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T09:07:52Z","timestamp":1779700072867,"version":"3.53.1"},"reference-count":32,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T00:00:00Z","timestamp":1778284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Micropulse transscleral cyclophotocoagulation (MP-TSCPC) selectively targets the ciliary body epithelium to reduce intraocular pressure (IOP). This study evaluated 6-month efficacy and safety of MP-TSCPC in primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEX) refractory to maximally tolerated topical therapy, and formally tested clinical equivalence between subtypes. Materials and Methods: In this single-arm prospective interventional cohort study with planned subgroup comparison, 58 eyes from 41 patients (POAG, 34; PEX, 24) underwent MP-TSCPC using the Cyclo G6 system with MicroPulse P3 probe at 2.0\u20132.2 W, 31.3% duty cycle, 90 s per hemisphere. IOP, best-corrected visual acuity (BCVA), antiglaucoma medications, and complications were recorded at baseline and at 30, 90, and 180 days. Six prespecified success criteria were evaluated, including the original \u226520% reduction threshold and the stricter Tekeli composite criteria. Outcomes are reported with 95% confidence intervals (CI) and Cohen\u2019s d. Intra-subject correlation from bilateral inclusion was addressed through a linear mixed-effects model, generalized estimating equations, and a 1000-iteration sensitivity analysis with random one-eye-per-patient subsampling. Equivalence was assessed by two one-sided tests (TOST). Results: Baseline IOP was 26.50 \u00b1 2.93 mmHg (POAG) and 25.92 \u00b1 2.47 mmHg (PEX). At 180 days, mean IOP reduction was 32.1% (95% CI 30.1\u201334.1) in POAG and 28.8% (95% CI 26.9\u201330.7) in PEX, both p &lt; 0.001 versus baseline, with very large within-group effect sizes (Cohen\u2019s d 4.24 and 4.81). All eyes achieved \u226520% reduction; under Tekeli criterion A (IOP \u2264 18 mmHg AND \u226520% reduction), success was 67.6% (POAG) and 54.2% (PEX). A 3.2 percentage-point between-group difference at 180 days was statistically detectable unadjusted (p = 0.024) but lost significance after clustering adjustment (mixed-model p = 0.101); equivalence was formally established at the \u00b17 percentage-point margin (TOST p = 0.004). Medication burden decreased in 41.2% (POAG) and 50.0% (PEX) of eyes. BCVA was preserved in all eyes; no serious adverse events were recorded. Conclusions: MP-TSCPC produces clinically meaningful, progressive IOP reduction over 6 months in both POAG and PEX, with no serious complications and clinically equivalent efficacy between subtypes. Longer-term studies with formal recording of baseline severity descriptors are warranted to confirm durability. Trial registration: ISRCTN registry, ISRCTN62227730.<\/jats:p>","DOI":"10.3390\/medicina62050920","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T08:06:26Z","timestamp":1779696386000},"page":"920","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of Micropulse Transscleral Cyclophotocoagulation in Primary Open-Angle and Pseudoexfoliative Glaucoma"],"prefix":"10.3390","volume":"62","author":[{"given":"Maja L. J.","family":"\u017divkovi\u0107","sequence":"first","affiliation":[{"name":"Ophthalmology Clinic, University Clinical Center Ni\u0161, Bulevar dr Zorana \u0110in\u0111i\u0107a 48, 18000 Ni\u0161, Serbia"},{"name":"Department of Ophthalmology, Faculty of Medicine, University of Ni\u0161, Bulevar dr Zorana \u0110in\u0111i\u0107a 81, 18000 Ni\u0161, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Zlatanovi\u0107","sequence":"additional","affiliation":[{"name":"Ophthalmology Clinic, University Clinical Center Ni\u0161, Bulevar dr Zorana \u0110in\u0111i\u0107a 48, 18000 Ni\u0161, Serbia"},{"name":"Department of Ophthalmology, Faculty of Medicine, University of Ni\u0161, Bulevar dr Zorana \u0110in\u0111i\u0107a 81, 18000 Ni\u0161, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2064-9520","authenticated-orcid":false,"given":"Nevena","family":"Zlatanovi\u0107","sequence":"additional","affiliation":[{"name":"Community Health Center Ni\u0161 in Ni\u0161, Vojvode Tankosi\u0107a 15, 18000 Ni\u0161, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mladen","family":"Brzakovi\u0107","sequence":"additional","affiliation":[{"name":"Special Hospital for Ophthalmology \u201cClinic Maja\u201d, Vizantijski Bulevar 8, 18000 Ni\u0161, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihailo","family":"Jovanovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Faculty of Medicine, University of Kragujevac, Svetozara Markovi\u0107a 69, 34000 Kragujevac, Serbia"},{"name":"Ophthalmology Clinic, University Clinical Center Kragujevac, Zmaj Jovina 30, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1016\/j.mayocpiqo.2022.09.007","article-title":"Updates on the diagnosis and management of glaucoma","volume":"6","author":"Wagner","year":"2022","journal-title":"Mayo Clin. 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