Safety and Efficacy of Ultrasound Ciliary Plasty As a Primary Intervention in Glaucoma Patients

Aim: To evaluate the safety and the efficacy of the ultrasound ciliary plasty (UCP) on the intraocular pressure (IOP) control in glaucomatous eyes without previous glaucoma surgery.

Methods: A retrospective study included patients with primary and secondary glaucoma who underwent UCP in Dar AlShifa Hospital, Kuwait between January 2017 to June 2018. High-intensity focused ultrasound procedures were performed under peribulbar anesthesia using the 2 generation probe with 8s duration of each of the 6 shots. Complete ophthalmologic examinations were scheduled pre-treatment, and at 1d, 1wk, 1, 3, 6 and 12mo post-treatment. Primary outcomes were the IOP reduction and success rates at 12mo, while the secondary outcomes were the occurrence of vision threatening complications and visual acuity.

Results: The records of 62 eyes of 62 patients were analyzed with mean age of 63.8y (67.7% males). There was statistically significant reduction in the mean IOP from 35.2±8.3 mm Hg before treatment to 20.6±8.7 mm Hg at 12 month (<0.0005) with a mean percentage IOP reduction of 42.3% with significant reduction in the mean number of antiglaucomatous drugs from 3.2±0.4 before treatment to 2.1±1.02 at 12mo (<0.0005). Qualified success was achieved in 77.4% of eyes at 12mo. No major intra- or post-treatment complications were reported.

Conclusion: Second-generation UCP prove to be effective in reducing IOP in naive glaucoma patients with lower success rates in cases of neovascular and uveitic glaucomas.