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Shlomo Melamed, Modi M Goldenfeld, Dan Cotlear; High-intensity focused ultrasound device in refractory Glaucoma patients. Results at 1 year. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6171.
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To evaluate the safety and efficacy of high-intensity focused ultrasound (HIFU, EyeOP1) cyclocoagulation by a miniaturized annular device containing six piezoceramic transducers in patients with refractory glaucoma.
Prospective interventional study. Twenty eyes of 20 patients with refractory glaucoma (POAG (n=7) and secondary glaucoma (n=7)) were treated with high-frequency transducers operating at 21 MHz. Ultrasound biomicroscopy (UBM) and a complete ophthalmic examination were performed before the procedure and at 1 day, 1 week, 1, 3, 6 and 12 months after the procedure.
Intraocular pressure was significantly reduced (P < 0.01) from a mean preoperative value of 36.4 ± 5.7 mm Hg to a mean postoperative value of 28.0 ± 8.8, 19.5 ± 8.8, 21.4 ± 10.4, 26.2 ± 10.2, 22.9 ± 8.9, 22.5 ± 10.0 mm Hg at 1 day, 1 week ,1 month, 3 months, 6 months and 12 months respectively. Four patients needed to be re-treated. The mean IOP reduction achieved was 38%. No major intraoperative or postoperative complications occurred. Minor postoperative corneal complications developed such as superficial punctate keratitis (n = 4) and central superficial corneal ulceration (n = 1) which had resolved with lubrication.
Ultrasonic circular cyclo-coagulation using high-intensity focused ultrasound delivered by a circular miniaturized device containing six piezoceramic transducers is an effective and well-tolerated method to reduce intraocular pressure in patients with refractory glaucoma.
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