Efficacy and Safety of Ultrasound Cycloplasty in Indian Eyes with Open-angle Glaucoma

Overview

Journal Indian J Ophthalmol

Specialty Ophthalmology

Date 2022 Dec 1

PMID 36453307

Authors

Chandrima Paul

J Divya

Subhrangshu Sengupta

Richa Kamal

Anujeet Paul

Ishani Mitra

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the safety and efficacy of ultrasound cycloplasty in eyes with primary or secondary open-angle glaucoma, not amenable to adequate control of intra-ocular pressure (IOP) with medical treatment.

Methods: Prospective interventional cohort study of 28 eyes of 28 subjects in a tertiary eye care centre in India in patients with open-angle glaucoma. All enrolled eyes underwent ultrasound cycloplasty with the second-generation probe with six shots of 8 s each, operated by a single surgeon between November 2018 and January 2020. They were followed up for a period of 12 months. The primary treatment outcome was IOP and the secondary outcomes were vision and postoperative complications.

Results: A total of 28 eyes of 28 patients were studied, and the mean age was 63.82 ± 6.46 years. Primary open-angle glaucoma (75%) was the most common etiology. There was significant reduction in IOP from the baseline (24.93 ± 4.27 mmHg) to the postoperative value (15.82 ± 3.14 mmHg) at the end of 12 months (P < 0.00001). Mean reduction in IOP was 9.14 ± 4.09 mmHg at 12 months (36.66%). Number of ocular hypotensives reduced significantly from baseline (3.32 ± 0.47) to 12-month postoperative follow-up (0.68 ± 0.74) (P < 0.00001). Qualified success was achieved in 89.28% eyes. No major complications were noted.

Conclusion: Ultrasound cycloplasty is found to be effective and safe in eyes with open-angle glaucoma because of the primary or secondary etiology, being more effective in the former.

Citing Articles

Efficacy and safety of ultrasound cycloplasty for the treatment of glaucoma: a Meta-analysis.

Wu T, Yin X, Li J, Lu P Int J Ophthalmol. 2023; 16(8):1317-1325.

PMID: 37602344 PMC: 10398525. DOI: 10.18240/ijo.2023.08.19.

Commentary: High-intensity focused ultrasound - A panacea in the making?.

Behera G, Kaliaperumal S Indian J Ophthalmol. 2022; 70(12):4172-4173.

PMID: 36453308 PMC: 9940530. DOI: 10.4103/ijo.IJO_2037_22.

References

Mastropasqua R, Fasanella V, Mastropasqua A, Ciancaglini M, Agnifili L . High-Intensity Focused Ultrasound Circular Cyclocoagulation in Glaucoma: A Step Forward for Cyclodestruction?. J Ophthalmol. 2017; 2017:7136275. PMC: 5420440. DOI: 10.1155/2017/7136275. View

Mastropasqua R, Agnifili L, Fasanella V, Toto L, Brescia L, Silvio Di Staso . Uveo-scleral outflow pathways after ultrasonic cyclocoagulation in refractory glaucoma: an anterior segment optical coherence tomography and in vivo confocal study. Br J Ophthalmol. 2016; 100(12):1668-1675. DOI: 10.1136/bjophthalmol-2015-308069. View

Aptel F, Denis P, Rouland J, Renard J, Bron A . Multicenter clinical trial of high-intensity focused ultrasound treatment in glaucoma patients without previous filtering surgery. Acta Ophthalmol. 2015; 94(5):e268-77. DOI: 10.1111/aos.12913. View

Deb-Joardar N, Reddy K . Application of high intensity focused ultrasound for treatment of open-angle glaucoma in Indian patients. Indian J Ophthalmol. 2018; 66(4):517-523. PMC: 5892053. DOI: 10.4103/ijo.IJO_1024_17. View

Marques R, Ferreira N, Sousa D, Barata A, Sens P, Marques-Neves C . High intensity focused ultrasound for glaucoma: 1-year results from a prospective pragmatic study. Eye (Lond). 2020; 35(2):484-489. PMC: 8027663. DOI: 10.1038/s41433-020-0878-0. View

Congdon N, OColmain B, Klaver C, Klein R, Munoz B, Friedman D . Causes and prevalence of visual impairment among adults in the United States. Arch Ophthalmol. 2004; 122(4):477-85. DOI: 10.1001/archopht.122.4.477. View

Aptel F, Begle A, Razavi A, Romano F, Charrel T, Chapelon J . Short- and long-term effects on the ciliary body and the aqueous outflow pathways of high-intensity focused ultrasound cyclocoagulation. Ultrasound Med Biol. 2014; 40(9):2096-106. DOI: 10.1016/j.ultrasmedbio.2014.04.017. View

Al-Ghamdi S, Tomey K, Al-Jadaan I . Transscleral neodymium:YAG laser cyclophotocoagulation for end-stage glaucoma, refractory glaucoma, and painful blind eyes. Ophthalmic Surg. 1993; 24(8):526-9. View

Traverso C, Walt J, Kelly S, Hommer A, Bron A, Denis P . Direct costs of glaucoma and severity of the disease: a multinational long term study of resource utilisation in Europe. Br J Ophthalmol. 2005; 89(10):1245-9. PMC: 1772870. DOI: 10.1136/bjo.2005.067355. View

10.

Lin S, Chen M, Lin M, Howes E, Stamper R . Vascular effects on ciliary tissue from endoscopic versus trans-scleral cyclophotocoagulation. Br J Ophthalmol. 2006; 90(4):496-500. PMC: 1856979. DOI: 10.1136/bjo.2005.072777. View

11.

Shen J, Wang Y, Yao K . Protection of retinal ganglion cells in glaucoma: Current status and future. Exp Eye Res. 2021; 205:108506. DOI: 10.1016/j.exer.2021.108506. View

12.

Charrel T, Aptel F, Birer A, Chavrier F, Romano F, Chapelon J . Development of a miniaturized HIFU device for glaucoma treatment with conformal coagulation of the ciliary bodies. Ultrasound Med Biol. 2011; 37(5):742-54. DOI: 10.1016/j.ultrasmedbio.2011.01.017. View

13.

Bolek B, Wylegala A, Wylegala E . Assessment of Scleral and Conjunctival Thickness of the Eye after Ultrasound Ciliary Plasty. J Ophthalmol. 2020; 2020:9659014. PMC: 7532393. DOI: 10.1155/2020/9659014. View

14.

Yamashita H, Sears M . Proof that the ciliary epithelium can regenerate. Exp Eye Res. 1978; 27(2):199-213. DOI: 10.1016/0014-4835(78)90089-1. View

15.

Melamed S, Goldenfeld M, Cotlear D, Skaat A, Moroz I . High-intensity focused ultrasound treatment in refractory glaucoma patients: results at 1 year of prospective clinical study. Eur J Ophthalmol. 2015; 25(6):483-9. DOI: 10.5301/ejo.5000620. View

16.

de ROETTH Jr A . Cryosurgery for the treatment of glaucoma. Trans Am Ophthalmol Soc. 1965; 63:189-204. PMC: 1310192. View

17.

Aptel F, Charrel T, Lafon C, Romano F, Chapelon J, Blumen-Ohana E . Miniaturized high-intensity focused ultrasound device in patients with glaucoma: a clinical pilot study. Invest Ophthalmol Vis Sci. 2011; 52(12):8747-53. DOI: 10.1167/iovs.11-8137. View

18.

Sabri K, Vernon S . Scleral perforation following trans-scleral cyclodiode. Br J Ophthalmol. 1999; 83(4):502-3. PMC: 1723018. DOI: 10.1136/bjo.83.4.501c. View

19.

Kosoko O, Gaasterland D, POLLACK I, Enger C . Long-term outcome of initial ciliary ablation with contact diode laser transscleral cyclophotocoagulation for severe glaucoma. The Diode Laser Ciliary Ablation Study Group. Ophthalmology. 1996; 103(8):1294-302. DOI: 10.1016/s0161-6420(96)30508-3. View

20.

Giannaccare G, Sebastiani S, Campos E . Ultrasound Cyclo Plasty in Eyes with Glaucoma. J Vis Exp. 2018; (131). PMC: 5908701. DOI: 10.3791/56192. View