Ultrasound Cyclo Plasty After Failed Glaucoma Surgery: Outcomes and Complications

Almobarak, Faisal A.; Alrubean, Ahmed; Alsarhani, Waleed K; Aljenaidel, Abdullah; Osman, Essam

doi:10.1007/s40123-022-00538-3

Cited by 6 publications

(4 citation statements)

References 16 publications

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“…Furthermore, whether the thermal effect of HIFU could cause cataracts in eyes with biometric features such as PACG is unknown. Five eyes developed prolonged or rebound anterior chamber inflammation (8.1%), which is lower than in our previous report 25. A wide difference exists in the literature in the incidence of anterior chamber inflammation after UCP because of the differences in sonification exposure time, the number of sectors treated, the heterogenicity of cases, and the history of prior glaucoma surgery.…”

Section: Discussioncontrasting

confidence: 63%

“…Five eyes developed prolonged or rebound anterior chamber inflammation (8.1%), which is lower than in our previous report. 25 A wide difference exists in the literature in the incidence of anterior chamber inflammation after UCP because of the differences in sonification exposure time, the number of sectors treated, the heterogenicity of cases, and the history of prior glaucoma surgery. Two eyes (3.2%) developed transient hypotony with choroidal detachment after UCP, which resolved after the application of cycloplegic agents.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of Ultrasound Cyclo Plasty in Primary Angle Closure Glaucoma

Almobarak

Alrubean

Alsarhani

et al. 2023

Journal of Glaucoma

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Précis: Ultrasound cyclo plasty (UCP) can be useful in decreasing the intraocular pressure (IOP) and burden of antiglaucoma medications in eyes with primary angle closure glaucoma (PACG). Nevertheless, baselines IOP was an important determinant for failure.Purpose: To evaluate the intermediate-term outcomes of UCP in PACG.Methods: This retrospective cohort study included patients with PACG who underwent UCP. The main outcome measures were IOP, number of antiglaucoma medications, visual acuity, and presence of complications. The surgical outcomes of each eye were classified as a complete success, qualified success, or failure based on the main outcome measures. Cox regression analysis was performed to identify possible predictors for failure.Results: Sixty-two eyes of 56 patients were included in the study. The mean follow-up period was 28.81 months ( ± 18.2). The IOP and number of antiglaucoma medications decreased from a mean of 23.03 ( ± 6.4) mmHg and 3.42 ( ± 0.9) to 15.57 ( ± 6.4) mmHg and 2.04 ( ± 1.3), respectively, in the 12 th month and to 14.22 ( ± 5.0) mmHg and 1.91 ( ± 1.5) in the 24 th month (P < 0.01 for all). The cumulative probabilities of overall success were 72.6 ± 5.7% and 54.8 ± 6.3% at 12 and 24 months, respectively. A high baseline IOP was associated with a higher risk of failure (hazard ratio = 1.10, P = 0.03). The most common complications were cataract development or progression (30.6%), rebound or prolonged anterior chamber reaction (8.1%), hypotony with choroidal detachment (3.2%), and phthisis bulbi (3.2%).Conclusions: UCP offers reasonable 2-year IOP control and reduction of the antiglaucoma medication burden. However, counseling on possible postoperative complications is needed.

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Section: Discussioncontrasting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Outcomes of Ultrasound Cyclo Plasty in Primary Angle Closure Glaucoma

Almobarak

Alrubean

Alsarhani

et al. 2023

Journal of Glaucoma

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“…It does not require incisions, has a fast recovery, and allows for quick subsequent anti-VEGF or PRP treatment. The procedure is simple and the treatment time is short, only a few minutes, which improves the efficiency of clinical treatment [13][14][15]25,28] . The results of this study showed that the IOP of both groups of patients with NVG significantly decreased at each postoperative time point compared to preoperative levels.…”

Section: Discussionmentioning

confidence: 99%

“…It has the characteristics of short treatment time without surgery and light postoperative reaction, and can be widely used in most types of glaucoma or patients with glaucoma surgery failure, with good IOP reduction effect. It avoids the damage to the eyes caused by continuous high IOP, and enables the condition of glaucoma patients to be controlled in a timely manner [12][13][14][15][16] . However, there are few comparative studies on the clinical efficacy of UCP and Ahmed glaucoma drainage valve (ADV) implantation in the treatment of NVG associated with retinal diseases.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the efficacy and safety of ultrasonic cycloplasty vs valve implantation and anti-VEGF for the treatment of fundus disease-related neovascular glaucoma

Fan,

Liu,

et al. 2023

Int J Ophthalmol

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AIM: To compare the clinical efficacy and safety of ultrasonic cycloplasty (UCP) vs Ahmed glaucoma drainage valve implantation (ADV) in addition to intravitreal anti-vascular endothelial growth factor (VEGF) for treatment of fundus disease-related neovascular glaucoma (NVG). METHODS: A total of 43 patients (45 eyes) with NVG secondary to fundus diseases underwent anti-VEGF combined with UCP or ADV from August 2020 to March 2022 were enrolled in this retrospective cohort study. Of them, 14 patients (15 eyes) were treated with both UCP and anti-VEGF as the UCP group and 29 patients (30 eyes) treated with both ADV and anti-VEGF as the ADV group. The success of the treatment was defined as intraocular pressure (IOP) between 11-20 mm Hg with or without using IOP-lowering drugs. IOP measurement, IOP lowering drugs at baseline and follow-ups period and complications were recorded. RESULTS: The average age was 63.03±9.95 and 52.27±12.89y in ADV and UCP groups, respectively (P=1.947). The fundus pathology included proliferative diabetic retinopathy in 42 eyes and retinal vein occlusion in 3 eyes. All eyes in both groups achieved successful treatment at 3mo. While the success rate was 90.0% (27/30) in the ADV group and 86.7% (13/15) in the UCP group at the last follow-up of 6mo (P>0.05). IOP was significantly lower with reduction of drug use than the baseline in both groups (both P<0.05). And the ADV group needed fewer anti-glaucoma drops than the UCP group from 1d to 3mo. The comfort scores of patients in the ADV group were significantly lower than those in the UCP group in the first week after the operation (P<0.05). CONCLUSION: UCP is an alternative to the ADV with the same efficacy but non-invasive for the treatment of NVG.

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