Ultrasound ciliary plasty in glaucoma treatment: A long-term follow-up study.
Bolek Bartłomiej, Wylęgała Adam, Wylęgała Edward
AI Summary
Ultrasound ciliary plasty (UCP) effectively lowered intraocular pressure (IOP) in glaucoma patients for three years, reducing medication needs. While not a complete cure, it's a well-tolerated option for refractory cases.
Abstract
Purpose
The present study aimed to evaluate the efficacy and safety of ultrasound ciliary plasty (UCP) in patients with open-angle glaucoma for three consecutive years.
Methods
Sixty-one patients (62 eyes) with primary and secondary glaucoma were enrolled to undergo UCP. The primary outcome measures were intraocular pressure (IOP) reduction, success rates, glaucoma medication use and visual acuity after UCP. An IOP reduction of 20% compared to the baseline value without re-intervention was considered a successful treatment. Complete success was defined as cessation of antiglaucoma medications. Secondary outcome measures included intraoperative and postoperative complications. Measurements were performed preoperatively and at the first week, and 1, 3, 6, 12, 18, 24, 30 and 36 months postoperatively.
Results
A total of 41 patients (41 eyes) were evaluated 36-month after UCP. The mean ± SD values of IOP preoperatively at 1 day, 1 week, 1; 3; 6; 12; 18; 24; 30 and 36 months postoperatively were 22.7 ± 5.0 mmHg, 17.1 ± 4.2 mmHg (p < 0.001), 15.7 ± 4.8 mmHg (p < 0.001), 18.8 ± 4.8 mmHg (p < 0.001), 17.3 ± 3.7 mmHg (p < 0.001), 16.9 ± 3.2 mmHg (p < 0.001), 16.6 ± 2.7 mmHg (p < 0.001), 16.3 ± 3.0 mmHg (p < 0.001), 15.8 ± 3.4 mmHg (p < 0.001), 15.3 ± 2.1 mmHg (p < 0.001) and 16.3 ± 3.0 mmHg (p < 0.001), respectively. The mean IOP at the last follow-up was reduced by 28.5%. The qualified success rate was 64.0%. All patients at 36-month follow-up visit required the use of antiglaucoma medications - none of the patients achieved complete success. The decrease in the number of antiglaucoma medications was statistically significant at each follow-up visit compared to the baseline. Choroid detachment was observed in three patients (4.8%), while macular oedema was observed in three patients (4.8%) after the procedure. No other major intraoperative or postoperative complications occurred.
Conclusion
Ultrasound ciliary plasty seems to be an effective and well-tolerated method to reduce IOP in patients with refractory glaucoma. Further studies with a larger group are needed to confirm the efficacy of this procedure.
MeSH Terms
Shields Classification
Key Concepts5
In a prospective cohort study of 61 patients (62 eyes) with primary and secondary glaucoma, ultrasound ciliary plasty (UCP) reduced mean intraocular pressure (IOP) from 22.7 ± 5.0 mmHg preoperatively to 16.3 ± 3.0 mmHg at 36 months postoperatively (p < 0.001), representing a 28.5% reduction.
In a prospective cohort study of 61 patients (62 eyes) with primary and secondary glaucoma, the qualified success rate for ultrasound ciliary plasty (UCP), defined as an IOP reduction of 20% compared to baseline without re-intervention, was 64.0% at 36 months.
In a prospective cohort study of 61 patients (62 eyes) with primary and secondary glaucoma undergoing ultrasound ciliary plasty (UCP), none of the patients achieved complete success (cessation of antiglaucoma medications) at the 36-month follow-up visit.
In a prospective cohort study of 61 patients (62 eyes) with primary and secondary glaucoma, ultrasound ciliary plasty (UCP) resulted in a statistically significant decrease in the number of antiglaucoma medications at each follow-up visit compared to baseline.
In a prospective cohort study of 61 patients (62 eyes) with primary and secondary glaucoma undergoing ultrasound ciliary plasty (UCP), choroid detachment was observed in three patients (4.8%) and macular oedema was observed in three patients (4.8%) after the procedure, with no other major intraoperative or postoperative complications.
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