Transient choroidal detachment after ultrasonic circular cyclocoagulation

Morais-Sarmento, Tiago; Figueiredo, Ricardo Rodrigues; Garrido, João; Rebelo, Ana Luísa

doi:10.1136/bcr-2019-231677

Cited by 4 publications

(5 citation statements)

References 5 publications

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“…We observed three cases of transient hypotony (IOP < 6 mmHg) (at D1, M1 and M3), but without choroidal detachment. There are also reports in literature of transient choroidal detachment after UCP that resolved after oral steroids [32]. Two patients in our study had vision loss, one for central retinal vein occlusion at M24 and one for glaucoma progression, but neither case was directly related to the UCP treatment.…”

Section: Discussionsupporting

confidence: 53%

Ultrasound Cyclo Plasty for Treatment of Surgery-Naïve Open-Angle Glaucoma Patients: A Prospective, Multicenter, 2-Year Follow-Up Trial

Figus

Posarelli

Nardi

et al. 2021

JCM

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Background: The purpose of this prospective study was to evaluate the efficacy and safety of the Ultrasound Cyclo Plasty (UCP) procedure using high-intensity focused ultrasound in surgery-naïve open-angle glaucoma patients. Methods: prospective, non-randomized, single-arm, multicenter clinical trial. Sixty-six eyes with primary open-angle glaucoma, intraocular pressure (IOP) ≥21 mmHg and with no history of filtering surgery were enrolled. Patients were treated by UCP with a therapy probe comprising six piezoelectric transducers, consecutively activated for 8 s each. Complete ophthalmic examination was performed before the procedure, 1 day after the procedure, and 1, 3, 6, 12, 18 and 24 months after the procedure. Primary outcomes were complete success (defined as IOP lowering from baseline ≥20% without additional glaucoma medications) and vision-threatening complications. Secondary outcomes were the presence of complications and the reduction of the number of medications used. Results: IOP was significantly reduced after one procedure (p < 0.05), from a mean pre-operative value of 24.3 ± 2.9 mmHg (n = 2.3 hypotensive medications) to a mean value of 15.9 ± 3.6 mmHg (n = 2.2 hypotensive medications) at 2 years (mean IOP lowering of 33%). Surgical success was achieved in 74% of eyes. Notwithstanding side effects such as transient anterior chamber inflammation, refractive error changes, transient hypotony and macular edema, no major intra or post-operative complications such as phthisis, induced cataract, neovascularization or significant vision loss were observed. Conclusions: Ultrasound Cyclo Plasty is a valuable, effective and well-tolerated procedure to lower IOP in patients with open-angle glaucoma without previous filtering surgery.

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Section: Discussionsupporting

confidence: 53%

Ultrasound Cyclo Plasty for Treatment of Surgery-Naïve Open-Angle Glaucoma Patients: A Prospective, Multicenter, 2-Year Follow-Up Trial

Figus

Posarelli

Nardi

et al. 2021

JCM

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“…This complication resolved 1 month after discontinuation of antiglaucoma medications. Hypotony and transient choroidal detachment was also observed in other studies (Figus et al, 2021;Leshno et al, 2020;Morais Sarmento et al, 2019;Rouland & Aptel, 2021). Macular oedema occurred in 4.8% of patients 1 month after the procedure, and all patients with oedema had coexistence of the epiretinal membrane.…”

Section: Discussionsupporting

confidence: 77%

“…However, it is an invasive procedure and is recommended in moderate glaucoma for patients undergoing cataract surgery (Berke et al, 2000;Siegel et al, 2015). This procedure also has side effects -the most common ones are IOP spikes, increased inflammation (compared to phacoemulsification without ECP), or dislocation of the intraocular lens (Noecker et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

Ultrasound ciliary plasty in glaucoma treatment: A long‐term follow‐up study

Bolek

Wylęgała

2022

Acta Ophthalmologica

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Cyclodestructive methods are used to treat moderate and severe forms of glaucoma (Dastiridou et al., 2018;Michelessi et al., 2018;Souissi et al., 2021). These methods reduce intraocular pressure (IOP) by decreasing aqueous humour production by partially damaging the nonpigmented epithelium of the ciliary body. Ultrasound ciliary plasty (UCP) for refractory glaucoma treatment, compared to the commonly used diode laser cyclodestruction, enables precise energy concentration through opaque structures, without uncontrolled absorption at the desired depth and area (Aptel et al., 2011;Aptel & Lafon, 2012;Charrel et al., 2011). Consequently, it reduces damage to the adjacent tissues. Until now few studies present results of 24-month follow-up (Figus

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“…Compared with other cyclodestruction procedures, UCP procedure had the highest safety features with lower incidences of mild and serious complications reported in the literature such as macular edema [7], hypotony [10], and choroidal detachment [21], and none of these had appeared in our study. There was no significant effect on patients’ vision acuity.…”

Section: Discussionmentioning

confidence: 65%

“…Thanks to the good safety profile, multiple UCP treatment may be performed in some patients with an insufficient IOP reduction after first UCP procedure until the target IOP is reached [14,15,[20][21][22]. DeGregorio et al [15] evaluated the effects of a second and possibly a third UCP procedure in patients who responded to a first procedure but in whom the target IOP was not reached 4 months after the procedure.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Cycloplasty in Chinese Glaucoma Patients: Results of a 6-Month Prospective Clinical Study

et al. 2021

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Purpose: The aim of this study was to evaluate the short-term efficacy and safety of ultrasound cycloplasty (UCP) procedure in Chinese glaucoma patients. Methods: As a single-centre, prospective, non-comparative study, 23 eyes of 23 patients suffering from glaucoma with uncontrolled intraocular pressure (IOP) ≥ 21 mmHg underwent a multi-dose UCP treatment with the activations of 6, 8 or10 sectors. Types of glaucoma include primary open-angle glaucoma (POAG) (7/23), primary angle closure glaucoma (PACG) (9/23) and secondary glaucoma (SG) (7/23). A complete ophthalmic examination including intraocular pressure (IOP) measurements was performed before UCP procedure and at 1 day, 1 month, 3months and 6 months after the procedure. An IOP reduction of ≥20% and IOP > 5 mmHg without increasing hypotensive medication at the follow-up visit was defined as therapeutic success. The post-operative complications were also recorded and compared to baseline for safety evaluation. Results: The mean baseline IOP of 23 treated eyes was 37.2 ± 12.1 mmHg. The IOP reduction after UCP procedure were 23%, 49%, 33% and 34% at 1 day, 1 month, 3 months and 6 months, respectively. Thus, the corresponding overall therapeutic success rates reached 61% (14/23), 83% (19/23), 65% (15/23) and 61% (14/23), respectively. Baseline IOPs of 8 and 10 sectors group (37.0 ± 9.9 mmHg and 50.1 ± 12.2 mmHg) were significantly higher than that of 6 sectors group (30.1 ± 8.2 mmHg). Therapeutic success rates of 6, 8 and 10 sectors groups reached 44% (4/9), 56% (5/9) and 100% (5/5), respectively. There were the highest percentage of IOP reduction (50% and 41%) and therapeutic success rate (6/7; 86% and 7/9; 78%) in SG group and PACG groups respectively. In addition, pre-operative ocular pain symptoms of four patients were all disappeared within one week after UCP. No serious intra-operative or post-operative complications occurred. Conclusion: UCP procedure is an effective and well-tolerated treatment to reduce IOP in Chinese glaucoma patients, which offered a novel alternative for glaucoma treatment.

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Transient choroidal detachment after ultrasonic circular cyclocoagulation

Cited by 4 publications

References 5 publications

Ultrasound Cyclo Plasty for Treatment of Surgery-Naïve Open-Angle Glaucoma Patients: A Prospective, Multicenter, 2-Year Follow-Up Trial

Ultrasound Cyclo Plasty for Treatment of Surgery-Naïve Open-Angle Glaucoma Patients: A Prospective, Multicenter, 2-Year Follow-Up Trial

Ultrasound ciliary plasty in glaucoma treatment: A long‐term follow‐up study

Ultrasound Cycloplasty in Chinese Glaucoma Patients: Results of a 6-Month Prospective Clinical Study

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