Conclusions: Micropulse transscleral laser treatment (MP-TLT) and continuous wave transscleral cyclophotocoagulation demonstrated comparable intraocular pressure across all follow-ups. MP-TLT was associated with significantly lower risks of ocular complications such as hypotony, prolonged inflammation, and phthisis bulbi.

Objective: To compare the efficacy and safety of micropulse transscleral laser treatment (MP-TLT) and continuous wave transscleral cyclophotocoagulation (CW-TSCPC) for the treatment of glaucoma or ocular hypertension.

Methods: A systematic search was conducted in PubMed, Cochrane Library, Embase, and ClinicalTrials.gov. Randomized controlled trials (RCTs) or cohort studies comparing MP-TLT and CW-TSCPC were included. Weighted mean differences (MDs) were computed for continuous endpoints and risk ratios (RRs) for binary endpoints, with 95% confidence intervals (CIs). Heterogeneity was assessed with I2 statistics. Software R, version 4.4.0, was used for statistical analyses. Subgroup analyses were conducted on glaucoma types.

Results: Eleven studies encompassing 1,054 eyes from 986 patients were included, with 47.4% receiving MP-TLT. There were no significant differences in IOP between CW-TSCPC and MP-TLT at one week, one month, three months, six months, 12 months, and 18 months of follow-up. The MP-TLT group required a significantly higher number of hypotensive medications but displayed significantly reduced risks of overall complications, ocular hypotony, prolonged inflammation, and phthisis bulbi compared to CW-TSCPC.

Conclusions: MP-TLT and CW-TSCPC showed similar efficacy in IOP control. However, MP-TLT demonstrated a greater safety profile, suggesting its potential suitability for patients requiring repeat interventions or those with lower tolerance for ocular complications.