Abstract
Purpose: :
To evaluate the safety and efficacy of high-intensity focused ultrasound delivered by miniaturized annular transducers in patients with refractory glaucoma.
Methods: :
Eight eyes of 8 patients with refractory glaucoma and uncontrolled intraocular pressure (IOP) were insonified using a ring comprising a six-sector transducer. UBM and a complete ophthalmic examination were performed before the procedure, and at 1 day, 1 week, 1, 3 and 6 months after the procedure. Main outcomes measures: Intraocular pressure reduction and intra- or post-operative complications.
Results: :
Intraocular pressure (IOP) was reduced from a mean preoperative value of 36.2 ± 7.4 mmHg (n= 2.9 glaucoma medications) to a mean postoperative value of 26.5 ± 5.7 (n=2.7), 24.8 ± 9.9 (n=2.7), 26.9 ± 6.6 (n=3.0), 29.6 ± 8.5 mmHg (n=2.8) and 25.2 ± 14.8 mmHg (n=2.8) at 1 day, 1 week, 1, 3 and 6 months respectively. No major intra- or post-operative complications occurred. UBM showed cystic involution of the ciliary body in 6 of the 8 eyes, and a suprachoroidal fluid space in 2 of the 8 eyes.
Conclusions: :
Ultrasonic coagulation of the ciliary body using high-intensity focused ultrasound delivered by a circular miniaturized transducer seems to be a promising and well-tolerated method to reduce IOP in patients with refractory glaucoma.
Clinical Trial: :
French Health Authority AFSSAPS, 2009-A01132-55
Keywords: intraocular pressure • ciliary body