Outcomes of Ultrasound Cyclo Plasty in Primary Angle Closure Glaucoma.
Almobarak Faisal A, Alrubean Ahmed, Alsarhani Waleed K, Aljenaidel Abdullah, Osman Essam A
AI Summary
UCP effectively lowers IOP and medication burden in PACG for up to two years, but high baseline IOP predicts failure and patients need counseling on potential complications like cataract progression.
Abstract
Prcis: 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.
MeSH Terms
Shields Classification
Key Concepts6
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).
In eyes with primary angle closure glaucoma (PACG) undergoing Ultrasound cyclo plasty (UCP), the mean IOP decreased from 23.03 (±6.4) mmHg to 15.57 (±6.4) mmHg at 12 months and to 14.22 (±5.0) mmHg at 24 months (P <0.01 for all).
In eyes with primary angle closure glaucoma (PACG) undergoing Ultrasound cyclo plasty (UCP), the number of antiglaucoma medications decreased from a mean of 3.42 (±0.9) to 2.04 (±1.3) at 12 months and to 1.91 (±1.5) at 24 months (P <0.01 for all).
The cumulative probabilities of overall success for Ultrasound cyclo plasty (UCP) in primary angle closure glaucoma (PACG) were 72.6±5.7% at 12 months and 54.8±6.3% at 24 months.
A high baseline intraocular pressure (IOP) was associated with a higher risk of failure for Ultrasound cyclo plasty (UCP) in primary angle closure glaucoma (PACG) (hazard ratio=1.10, P =0.03).
The most common complications of Ultrasound cyclo plasty (UCP) in primary angle closure glaucoma (PACG) 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%).
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