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Stefano Sebastiani, Giuseppe Giannaccare, Marco Pellegrini, Lara E Urbini, Luciana Carmassi, Ennio Bulone, Fulvio Bergamini, Emilio C Campos; Intraocular Pressure Reduction After Ultrasound Cyclo Plasty for Glaucoma: Relationship With Biometric Parameters and Intraocular Inflammation. Invest. Ophthalmol. Vis. Sci. 2018;59(9):6100.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effect of high-intensity focused ultrasound coagulation of the ciliary body on intraocular pressure (IOP) in glaucoma patients, and to investigate possible correlations with axial length (AL), anterior chamber depth (ACD), and intraocular inflammation.
Multicenter prospective interventional study including 48 eyes affected by different types of glaucoma. Patients were treated by Ultrasound Cyclo Plasty (UCP) device (EyeOP1, EyeTechCare, France) which performs a selective coagulation of the ciliary body using ultrasound beams. IOP was measured before and 1 day, 1 and 2 weeks, 1, 3 and 6 months after the treatment. AL and ACD were measured by optical biometry (Lenstar LS-900, Haag-Streit, Switzerland) before the procedure. Intraocular inflammation was evaluated in a subgroup of 18 patients by laser flare-cell photometry (FM-500, Kowa, Japan) before and 1 day, 1 and 2 weeks, 1 and 3 months after the treatment.
The mean IOP was significantly reduced from 24.5±6.0 to 15.8±4.4 mmHg six months after the treatment (p<0.001). A significant negative correlation was found between the AL and the IOP reduction at 1 day (R=-0.438; p=0.002), 1 week (R=-0.377; p=0.012) and 1 month (R=-0.324; p=0.032). IOP reduction at 1 day, 1 week and 1 month was significantly higher in patients with AL ≤24 mm compared to those with higher AL (respectively 10.6±6.5 vs 4.4±4.4 mmHg; p=0.004; 12.0±7.3 vs 8.0±5.9; p=0.047; 12.6±9.5 vs 6.8±5.5; p=0.018). After treatment, mean intraocular inflammation rapidly increased from 12.1±7.5 to 64.1±53.9 ph/ms at 1 day (p<0.001) as expression of the disruption of the epithelial cells of the ciliary body, and then slightly decreased partially returning to pre-operative values at 3 months. Significant correlation was found between ACD and intraocular inflammation rise after treatment (R=-0.568; p=0.034) while no direct correlation was found between intraocular inflammation and IOP reduction.
UCP is an effective non-incisional technique for reducing IOP. A greater IOP reduction was found in eyes with shorter AL compared to myopic eyes. Intraocular inflammation rise was greater in eyes with shallow ACD, and its complete recovery to preoperative value was reached within 3 months after the treatment, possibly indicating this time window as the proper timing for eventual repeated treatments, if needed.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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