Micropulse Cyclophotocoagulation Versus Continuous Wave Cyclophotocoagulation: A Meta-Analysis

Précis: – In this systematic review, we find that CW-CPC produces more sustained IOP lowering in children compared to MP-CPC. Purpose: – Micropulse cyclophotocoagulation (MP-CPC) and Continuous cyclophotocoagulation (CW-CPC) are both surgical interventions used to decrease intraocular pressure (IOP) in pediatric glaucoma. Recent publications have shown conflicting results regarding the effectiveness of MP-CPC compared to CW-CPC, which this systematic review and meta-analysis aims to evaluate. Methods: – From inception through March 2025, PubMed, Embase, Scopus, Cochrane Library, and ScienceDirect were searched for studies comparing MP-CPC and CW-CPC in treating pediatric glaucoma, with IOP reported at different time intervals. A random effects model was used across all analyses. Results: – At 12 months, CW-CPC showed a significantly greater reduction in IOP compared to MP-CPC (MD: -6.88 mmHg, 95% CI: -9.46 to -4.30; P < 0.00001). No significant differences in IOP lowering were observed at 1, 3, and 6 months. Overall, CW-CPC was superior in reducing IOP (MD: -4.23 mmHg, 95% CI: -6.51 to -1.95; P = 0.0003; I² = 80%) at the last follow-up. Conclusion: – CW-CPC shows a significantly greater reduction in IOP than MP-CPC, particularly at long-term follow-up. These findings highlight the sustained efficacy of CW-CPC compared to MP-CPC in the management of pediatric glaucoma.