How Safe and Effective is Micropulse Transscleral Cyclophotocoagulation in Patients With Uncontrolled Glaucoma?

If the subject agrees to participate in this study, he/she will come in for a screening visit
to make sure they qualify for the study. Following the surgical procedure, principal
investigator will perform a standard postoperative examination at Day 1, Week 1, Month

1, Month 3, Month 6 and Month 12, in addition to any other visits the investigator feels may
be necessary.

Screening Visit: At the screening visit, the subjects medical history and current medications
will be reviewed. Pre-operative eye pressure and visual acuity will be noted. The Kowa Flare
Meter-500 laser flare meter and slit lamp (the table-top microscope used for examining the
eye) will be used to measure inflammation in subjects anterior chamber (the fluid-filled
space between the iris (colored part of the eye) and cornea (clear front part of the eye that
covers the iris and pupil).

Surgery: On the day of the subjects surgery, the subject will undergo the standard procedure
for transscleral cyclophotocoagulation (TSCPC) laser surgery using the micropulse delivery
mode of diode laser. After the Principal investigator finishes with the laser, he/she will
perform anterior chamber paracentesis, which will help reduce the pressure in the subjects
eye quickly and temporarily. To do this, the principal investigator will puncture the cornea
(the clear front part of the eye that transmits and focuses light into the eye) to remove
some of the aqueous (fluid inside the eye). Paracentesis is usually not done if TSCPC is
performed using the "continuous" delivery mode.

Post-Operative Exams: At each of the post-operative office visits (Day 1, Week 1, Months 1,
3, 6 and 12) a detailed medical/eye history will be taken, including all current medications,
vision will be tested and an eye examination will be performed, including measurement of eye
pressure. Subject will be asked about his/her comfort level in regards to pain. At visit Day
1 and Month 1 the amount of anterior chamber inflammation will again be measured (as
described in Screening Visit).

Inclusion Criteria: Patients with a minimum of 6 months follow-up with uncontrolled
glaucoma as defined by:

- Progression and/or intraocular pressure above target despite maximal tolerated medical
therapy

- Evidence of glaucomatous optic nerve damage and glaucomatous visual field loss in at
least one hemifield

Exclusion Criteria:

- Age ≤ 20 years old.

- Patients who had undergone previous intraocular surgery or ocular laser treatment
within 2 months of enrolment.

- Patients who had undergone previous conventional continuous wave mode TSCPC within 1
months of enrolment.

- Patients with significant scleral thinning as defined by greater than 1 clock hour.

- Patients with any medical condition that would preclude the subject from providing
informed consent or reliable and valid data.

- Patients enrolled in other prospective clinical trials.

- Albino patients that have no pigmentation