Re-Thinking Glaucoma Care
MICROPULSE® TRANSSCLERAL LASER THERAPY (TLT)
A cost-effective combination of safety, efficacy, durability and repeatability in a non-incisional approach to glaucoma care. MicroPulse Transscleral Laser Therapy via the MicroPulse P3® Device offers you and your patients a therapy which can be introduced prior to, in conjunction with and following all other available glaucoma treatment options, and the ability to treat at several different time points throughout the course of the disease.
- A success rate of 60% to 80%1-17
- Leaves future treatment options open
- Achieves IOP reduction of 30% to 45%1, 3, 6, 9-15, 17, 18
- Durability of up to 72 months with 3 retreatments19
- Used in 38 of the 39 best hospitals in the United States*
- Reduction in drug burden in eye drops and oral medications1-4, 6-13, 18
- Revised probe now available with improved ease of use, visualization, fit, and coupling
- Limited amount of immediate follow-up
- Patient downtime is significantly low
- Low investment for high utility
- Economic savings to patients
- Covered under CPT 66710 in the U.S.A.**
1 Zaarour K, et al. J Glaucoma 2019. 2 Subramaniam K, et al. Cornea 2019. 3 Nguyen AT, et al. Eur J Ophthalmol 2019. 4 Barac R, et a. Romanian J Ophthalmol 2018. 5 Sanchez FG, et al. Arch Soc Esp Oftalmol 2018. 6 Lee JH, et al. J Glaucoma 2017. 7 Sarrafpour S, et al. Ophthalmology Glaucoma 2019. 8 Awoyesuku EA, et al. JAMMR 2019. 9 Abdelrahman AM, et al. J Glaucoma 2018. 10 Aquino MC, et al. Clin Exp Ophthalmol 2015. 11 Jammal AA, et al. Arq Bras Oftalmol 2019. 12 Tan A, et al. Clin Experiment Ophthalmol 2010. 13 Williams AL, et al. J Glaucoma 2018. 14 Varikuti VNV, et al. J Glaucoma 2019. 15 Souissi S, et al. Eur J Ophthalmol 2019. 16 Magacho L, et al. Lasers Med Sci 2019. 17 Magacho L, et al. J Glaucoma 2019. 18 Yelenskiy A, et al. J Glaucoma 2018. 19 Aquino M, et al. European Glaucoma Society 2016. * As ranked by U.S. News and World Report. ** National reimbursement for CPT code 66710 in the United States is as follows: $453 for physician payment in physician office, $400 for physician payment in ASC, $836 for facility payment in ASC, $400 for physician payment in hospital outpatient department, and $1,934 for facility payment in hospital outpatient department.
ARTICLES
MicroPulse Transscleral Laser Therapy After Tube Shunt Surgery
April 2020 - Glaucoma Today
By Brian M. Jerkins, MD
2019
Outcome of MicroPulse Transscleral Photocoagulation in different Types of Glaucoma
December 2019 - Clinical Ophthalmology
By Ahmed Al Habash, MD
Micropulse Transscleral Diode Laser Photocoagulation: What We Do and Don't Know
December 2019 - Medscape
By Shuchi B. Patel, MD
MicroPulse Trans-scleral Laser Therapy for Glaucoma
December 2019 - Glaucoma Physician
By Vital Costa, MD
Outcomes of MicroPulse Transscleral Cyclophotocoagulation in Eyes With Good Central Vision
October 2019 - Journal of Glaucoma
By Venkata Varikuti, MD
MicroPulse cyclophotocoagulation effective in keratoplasty eyes
August 2019 – EyeWorld
By Robert Noecker, MD
Cook County Health presents glaucoma studies at ARVO
May 2019 – Ocular Surgery News
By Michael C. Giovingo, MD
Study shows MicroPulse laser controls IOP after keratoplasty
May 2019 – Ocular Surgery News
By Jessica Minjy Kang, MD
Avoiding issues from inflow procedures
May 2019 – Ophthalmology Times
By Jeffrey Kammer, MD
Subthreshold laser shows favorable foveal remodeling after macular hole closure
May 2019 – Ocular Surgery News
By Boris Stanzel, MD
Standardizing techniques for MicroPulse cyclophotocoagulation needed
April 2019 - Healio Ocular Surgery News
By Jella An, MD
Outcomes of Micropulse Transscleral Cyclophotocoagulation in Uncontrolled Glaucoma Patients
March 2019 – Glaucoma Journal
By Ziad Khoueir, MD
Transscleral MicroPulse CPC in Open-Angle Glaucoma
February 2019 – Glaucoma Today
By Fahad Khan, MD; and Rohit Krishna, MD
The role of MicroPulse therapy
February 2019 – Ophthalmology Management
By Ahad Mahootchi, MD
Which MIGS for which patient?
January 2019 – Ophthalmology Times
By Brian A. Francis, MD, MS
2018
Micropulse Transscleral Cyclophotocoagulation: A Hypothesis for the Ideal Parameters
November 2018 - Medical Hypothesis, Discovery &Innovation Ophthalmology Journal
By Tomas M. Grippo, MD
Try this laser before you go to the OR
October 2018 - Ocular Surgery News
By Melissa Toyos, MD
Video: MicroPulse for mild to moderate stage glaucoma
August 2018 - Ocular Surgery News
By Sandra Fernando-Sieminski, MD
MicroPulse not just for end-stage glaucoma patients
August 2018 - Ocular Surgery News
By Sandra Fernando-Sieminski, MD
Reassessing TSCPC’s role
August 2018 - The Ophthalmologist
By David Gossage, DO
Micropulse P3™ (MP3) Laser for Glaucoma: An Innovative Therapy
August 2018 – JOCGP
By Maria Cecilia Aquino, MD
Efficacy and safety of Micropulse® transscleral cyclophotocoagulation in glaucoma
August 2018 – Archivos Espanola
By F.G. Sancheza, MD
MicroPulse stimulates cells
May 2018 - Ocular Surgery News
By Melissa Toyos, MD
Micropulse cyclophotocoagulation minimizes post-treatment sequelae
May 2018 - Ocular Surgery News
By Soshian Sarrafpour, MD
MicroPulse cyclophotocoagulation — the ultimate in flexibility
March 2018 - Ocular Surgery News
By Melissa Toyos, MD
MicroPulse technology reduces IOP in wide range of glaucomatous eyes
February 16, 2018 - Ocular Surgery News
By Shan Lin, MD
2019
Applying micropulse transscleral cyclophotocoagulation for early-stage glaucoma
November 2017 - Ophthalmology Times
By Robert J. Noecker, MD
MicroPulse technology allows safe treatment of glaucoma
November 2017 - Ocular Surgery News
By David Gossage, DO
Video: Micropulse cyclophotocoagulation a safe alternative to incisional glaucoma procedures
October 2017 - Ocular Surgery News
By Marc Toeteberg-Harms, MD
New Laser Therapies for Glaucoma
September 2017 - Cataract & Refractive Surgery Today
By Nisha Chadha, MD
FREQUENTLY ASKED QUESTIONS
How can I order the MicroPulse P3 Device?
The MicroPulse P3 Device comes in a box of six. To place an order, speak with your local sales rep or distributor, or contact customer service at 650.962.8100 or customerservice@iridex.com.
What is the CPT code?
CPT code for cyclophotocoagulation is 66710
What is the shelf life of MicroPulse P3, G-Probe, and G-Probe Illuminate?
3 years
Can the MicroPulse P3 Device be reused?
No. The MicroPulse P3 Device is Indicated for single-use
What is MicroPulse® Technology?
MicroPulse technology is a tissue-sparing solution where a continuous-wave laser beam is chopped into a train of tiny, repetitive, low energy pulses separated by a brief rest period which allows tissue to cool between laser pulses.
MICROPULSE TLT DURING COVID-19
As the COVID-19 pandemic continues, our thoughts go out to those who have been impacted. Our priority at IRIDEX is to support our customers, their patients and our employees. Over the past few months, ophthalmologists from around the world have been exchanging ideas and strategies to adapt to new social distancing guidelines, infection control measures, and treatment options to best manage their patients. During this time of uncertainty, many of our customers have shared with us how MicroPulse Transscleral Laser Therapy (TLT) remains a beneficial therapy for a variety of reasons. MicroPulse TLT:
- is non-incisional, safe, and effective
- can be performed in the office
- takes less than 5 minutes to performed
- entails minimal follow-up
- leaves future treatment options open
- can be applied for a wide range of glaucoma types and severity
- typically allows patients to return to normal activities within 24 hours
- uses the Cyclo-G6 laser console that can be disinfected easily
- uses a sterile, single-use, MicroPulse P3 fiber-optic delivery device
In a webinar titled “How I Am Treating Glaucoma During the COVID-19 Pandemic,” Dr. Jason Bacharach of California discussed how the current COVID-19 pandemic has changed the way clinicians treat and manage glaucoma. “Most patients presenting for urgent care usually require stronger IOP control, so I have turned to MicroPulse TLT to bridge this gap and I treat them in the office. This is a great tool for right now,” he said.
In a different webinar, Dr. Rajen Desai of New Jersey said: “Patients did not feel comfortable having to come back to the office for multiple post-op visits if I proposed incisional glaucoma surgery, so I realized I needed something dependable, predictable, safer, and low risk during this time. MicroPulse is playing a particular stronghold now that patients are averse to getting things done in general. They prioritize safety above all else, and that’s where MicroPulse shines because I tell them there is a very low risk of endophthalmitis.”
In a webinar about the evolution and versatility of MicroPulse TLT, Dr. Marc Toeteberg-Harms of Switzerland said: “My elderly patients were scared to be seen in the hospital. MicroPulse TLT enabled me to be able to treat in the office immediately thus avoiding a second consultation. Plus, post-op complications are low and this minimizes post-op visits. The outside of the laser machine and the footswitch are easy to clean.”
Dr. Branda Alegría of Guadalajara, Mexico contacted us via instagram to share a few photos and she told us the following: “MicroPulse Transscleral Laser Therapy is my best ally during the COVID-19 pandemic when facing challenging glaucoma cases.”
We are here to help you. We are thankful and honored to be supporting hundreds of ophthalmologists and patients during this dificult time. As we go forward together, please know that we value your questions, ideas and feedback. If there is something in particular that you need, please email us at glaucoma@iridex.com or contact your IRIDEX representative. Stay safe and healthy.
Treating Glaucoma with MicroPulse Therapy During COVID-19 by Dr. Marc Toeteberg
How I Am Treating Glaucoma During the COVID-19 Pandemic by Dr. Jason Bacharach
MicroPulse TLT: an Option for Glaucoma Treatment During COVID-19 by Dr. Rajen Desai
REVIEWS
"The revised MicroPulse P3 Device is intuitive and easy to use. The design delivers energy in a much more consistent fashion and allows for very stable contact on the sclera.”
Brian A. Francis, MD, MS
Doheny Eye Institute, UCLA
“I was using the Cyclo G6 glaucoma laser for refractory glaucoma patients, but as I saw the results and how comfortable the patients were, I started to expand its use, and now I use it for various types of glaucoma cases.”
Sandra Fernando Sieminski, MD
Ross Eye Institute, Buffalo, NY USA
"When treating patients with glaucoma, my number one goal is to prevent blindness and my number two goal is to prevent incisional glaucoma surgery, and MicroPulse Therapy can help me to achieve both.”
Nathan Radcliffe, MDNew York Eye Surgery Center
“The technique for performing MicroPulse TLT for glaucoma was already great in the past. The minimal tissue damage is a major advantage of MicroPulse TLT over standard cyclophotocoagulation in my opinion. Iridex has done a great job improving the MicroPulse P3 Device. The ergonomic enhancements made to the design of the MicroPulse P3 Device now allows a smoother movement during treatment. I feel much more comfortable, and this is resulting in an even safer and more stable treatment for glaucoma.”
Marc Toeteberg-Harms, MD, FEBO
Zurich, Switzerland
“I have performed over a hundred MicroPulse TLTs, and have not experienced a single case of iritis or CME. MicroPulse TLT is safe, effective, and can be done in the office and OR in less than 5 minutes. For surgeons who may not feel comfortable adopting the newest MIGS devices but want something effective and safe to reduce IOP with the simplest learning curve, MicroPulse TLT is an outstanding option.”
Rajan Desai, MD, FACS
East Brunswick, NJ
“Numerous published studies and clinical experience in the US, Europe and Asia over the last several years have demonstrated that it is a safe and effective option to decrease both IOP and the number of topical medications necessary in many glaucoma patients. I regularly treat a wide variety of glaucoma patients with it, and my patients are very happy with the results.”
Ahad Mahootchi, MD
The Eye Clinic of Florida, Zephyrhills, FL USA
“MicroPulse TLT has become an irreplaceable tool in my daily practice. It has allowed me to better individualize the care of my glaucoma patients, minimizing risks and allowing for clinical success even in challenging scenarios where I used to have none or few and risky treatment options. It is an evolving technology, and as we continue to learn more about it, we will unveil its full potential.”
Tomas M. Grippo, MD
Grippo Glaucoma Center, Buenos Aires, Argentina
“Since 2016, I have loved having MicroPulse TLT in my surgical toolbox for many types of glaucoma, including those in late stage and refractory stages. I am a big fan because this can often save someone from incisional surgery. Of course, selecting the right patient is key to ensure good outcomes and minimal side effects.”
Monisha Vora, MD
Wills Eye Hospital
“In a study that I performed with 71 eyes of 68 patients, I found that MicroPulse TLT demonstrated good efficacy and safety profiles with minimal vision-threatening complications in treating a variety of glaucoma types.”
Ahmed Al Habash, MD
Imam Abdulrahman Bin Faisal University, Saudi Arabia
“The MicroPulse P3 Device has become an essential part of my armamentarium for use in glaucoma surgical procedures. It provides a very safe and efficacious solution for IOP control. I have used MicroPulse P3 for some of my most complicated cases but also I feel comfortable enough using it for patients with earlier disease in which we want to avoid a filtering bleb or the placement of hardware in the eye.”
Robert Noecker, MD, MBA
Ophthalmic Consultants of Connecticut, Fairfield, CT USA
“MicroPulso laser therapy helps our patients by significantly reducing intraocular pressure without the need for invasive surgeries. We are very happy with the results.”
Vanessa Liberato, MD
Santo Domingo, Republica Dominicana
“I have been using MicroPulse TLT in my practice for more than 2 years. MicroPulse mode has proven to be an efficacious choice for many of my glaucoma patients, with significant reduction in pressure and medication use for most. I have found that after MicroPulse TLT procedures, my patients experience less pain and less post-procedural inflammation than after traditional CPC.”
Jonathan S. Myers, MD
Wills Eye Hospital
“The MicroPulse P3 Device has given me over 30% IOP lowering. With patients that are non-compliant with their medication, or we are really trying to keep off their medication, the MicroPulse P3 device allows me to treat patients more aggressively.”
Steven Vold, MD
Vold Vision, Fayetteville, AR USA
“MicroPulse Transscleral Laser Therapy is my best ally during the COVID-19 pandemic when facing challenging glaucoma cases. I have been using MicroPulse TLT with the Cyclo G6 Laser to treat glaucoma for nearly two years and my outcomes have been excellent so far.”
Branda Alegría, MD
Guadalajara, Mexico
“I have been impressed that the MicroPulse therapy can deliver pressure lowering in a broad range of glaucomas, including mild and moderate patients who I want to free from the adverse effects of drops.”
Rolando Toyos, MD
Toyos Clinic, Nashville, TN USA
“I have found the MicroPulse P3 Device to be a non-incisional, easy, and safe way to reduce pressure anytime my patients need it, and it is predictable and highly efficacious.”
Melissa Toyos, MD
Toyos Clinic, Nashville, TN USA
“Today we treated 8 patients, and we saw considerable reductions in IOP in all of them. Plus, we avoided the need for a valve in two of the patients.”
Gustavo Aviles, MD, PhD
Lima, Peru
“In my practice, the addition of MicroPulse TLT has proven to be a safe, effective and reliable approach for lowering IOP. Personally, I have used MicroPulse TLT on patients with mild to wild glaucoma – and for good reason. It is safe and effective without yielding major impact on the target tissue, and it’s repeatable if necessary.”
Nir Shoham-Hazon, MD
Miramichi, Canada
“I have been using MicroPulse TLT to treat glaucoma for the past few months. The outcomes have been positive. I particularly use it in patients with cataract and glaucoma to reduce or eliminate their dependency on medications.”
José Antonio Bermudez Magner, MD
Mexico City, Mexico
“MicroPulse TLT shows promise for surgeons who wish to avoid further invasive procedures. It also works well in tandem with tube shunt implants before primary implantation. Overall, the procedure is straightforward and fast, with easy recovery and minimal complication rates.”
Brian M. Jerkins, MD
Hamilton Eye Institute, Memphis, TN USA
“It is important to have many choices in managing chronic diseases like glaucoma. Because MicroPulse laser is non-incisional and repeatable, it keeps all other options open.”
Makoto Aihara MD, PhD
University of Tokyo, Japan
“MicroPulse P3 is very effective in the treatment of late stage glaucoma. Early clinical data suggest it may also be an effective treatment to reduce IOP in mild to moderate glaucoma.”
Maria Cecilia Aquino, MD
National University Hospital Singapore
“MicroPulse P3 for glaucoma has improved my ability to treat more patients with a repeatable procedure.”
Poemen Chan, MD
The Chinese University of Hong Kong