CW-CPC shows greater sustained IOP reduction than MP-CPC in pediatric glaucoma meta-analysis

This systematic review and meta-analysis compared micropulse cyclophotocoagulation (MP-CPC) with continuous wave cyclophotocoagulation (CW-CPC) for intraocular pressure reduction in children with glaucoma. The analysis included comparative studies with a mean follow-up of 12.0 months, though the total sample size and specific study designs of included trials were not reported.

At 12 months, CW-CPC showed significantly greater IOP reduction than MP-CPC, with a mean difference of -6.88 mm Hg (95% CI: -9.46 to -4.30; P < 0.00001). At 1, 3, and 6 months, no significant differences in IOP lowering were observed between techniques. In the overall analysis of IOP reduction at last follow-up, CW-CPC remained superior with a mean difference of -4.23 mm Hg (95% CI: -6.51 to -1.95; P = 0.0003).

Key limitations include high statistical heterogeneity (I² = 80%) in the overall analysis, which suggests substantial variability between included studies. Safety outcomes, adverse events, tolerability, and discontinuation rates were not reported. The funding sources and potential conflicts of interest were also not reported.

For clinical practice, these findings suggest CW-CPC may provide more sustained IOP control in pediatric glaucoma compared with MP-CPC, particularly beyond 6 months. However, the absence of safety data and high heterogeneity limit definitive conclusions. Clinicians should consider these results alongside individual patient factors and the procedural risk profiles of each technique.