The National University Hospital (NUH) in Singapore has pioneered a special type of probe to use in the treatment for late-stage glaucoma. This modified procedure is even being used internationally at various eye hospitals.

The therapy known as the Micropulse Transscleral Cyclophototherapy (MPTCP) was invented by Associate Professor Paul Chew, Senior Consultant with NUH’s Department of Ophthalmology. It was rolled out in 2007 to treat patients with advanced glaucoma and it works on the same micropulse technique that has been utilised for laser treatment of retinal diseases.

Advantages of the new technique

Chew came up with a customised probe to administer a series of laser energy in short, gentle pulses into the eye. The procedure takes 100 seconds to complete which is half the time needed for conventional laser treatment.

This improvement proves to be a safer and more effective laser treatment procedure as compared to the usual Transscleral Cyclophotocoagulation (TCP) that delivers longer pulses of high-intensity laser energy into the eye. Besides being time-saving, the MPTCP treatment is also less painful and destructive due to the decrease in maximum temperature.

An exploratory, comparative study was done in 2009 at NUH using a prototype of the probe and concluded that the MPTCP provides a more predictable and consistent effect in reducing eye pressure compared to conventional laser therapy.

After 12 months of therapy, 75% of the patients who received the MPTCP had their eye pressure reduced which is an improvement from the 29% who received the conventional TCP. Additionally, no complications were reported of the patients who went through the MPTCP, however, 20% who underwent the conventional TCP had. Upon reviewing the same group of patients who underwent MPTCP six years later, it was found that their eye pressure remained well-controlled throughout the period.

Global impact of MPTCP

Eye surgeons internationally have been using the patented, customised probe since 2015. More than 45,000 patients from the United States, United Kingdom, Philippines, Indonesia and more have benefited from the new therapy over the last two years. Since last year, over 300 patients in NUH itself have successfully undergone this therapy.

“Glaucoma is a chronic disease that carries a significant burden on one’s health. There is a pressing need for innovative interventions to treat glaucoma in order to preserve a patient’s vision and thus, decrease disability and health care costs,” said Chew. 

“Patients with advanced glaucoma can now look forward to a treatment which enhances their quality of life,” he added. He is planning on modifying the probe further in the future and evaluating its efficacy in patients with mild to moderate glaucoma.

Glaucoma is a major cause of irreversible blindness worldwide. Accounting for 40% of blindness in Singapore, it affects about 3% of those over 40 years old and the risk increases with age. MIMS

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