Efficacy and safety of ultrasonic circular cyclocoagulation with second-generation probe in glaucoma: A retrospective study


Autoři: Chloé Chamard aff001;  Vincent Daien aff001;  Hyosun Han aff001;  David S. Greenfield aff004;  Max Villain aff001
Působiště autorů: Department of Ophthalmology, Gui de Chauliac Hospital, Montpellier, France aff001;  INSERM (Institut National de la Santé Et de la Recherche Médicale), Montpellier, France aff002;  The Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia aff003;  Department of Ophthalmology, University of Miami Miller School of Medicine, Bascom Palmer Eye Institute, Palm Beach Gardens, Florida, United States of America aff004
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227389

Souhrn

Background

To assess the efficacy and safety of the second-generation probe of ultrasonic circular cyclocoagulation (UC3) in naive or refractory glaucoma, with a 6-month follow-up.

Methods

A retrospective consecutive case-series study included patients having a UC3 procedure with the second-generation probe of the EyeOP1 device, intraocular pressure (IOP) ≥ 21 mmHg and under maximum tolerated medical treatment, with or without previous glaucoma surgery. Surgical success was defined at the 6-month post-operative visit as IOP > 5 and ≤ 21 mmHg with IOP reduction ≥ 20% from baseline, without any reoperation, and visual acuity better than negative light perception.

Results

100 patients were included and 97 (97.0%; 97 eyes) attended the 6-month follow-up. At 6 months, surgical success was obtained in 48 eyes (49.5%). Intraocular pressure was reduced from a mean ± SD preoperative value of 28.0 ± 5.6 mmHg to 19.3 ± 7.1 mmHg at 6 months (p<0.0001). The proportion of eyes requiring oral acetazolamide decreased from 57.0% to 30.0% between baseline and 6 months after surgery (p = 0.0007). We observed 15 (15.0%) cases of postsurgical macular edema, 8 (8.0%) of hypotony, and 20 (20.0%) of visual acuity loss > 2 Snellen lines. Postsurgical macular edema was associated with a history of epiretinal membranes, uveitis or retinal detachment. Risk factors for hypotony were a history of diabetes or trabeculectomy.

Conclusions

The second-generation UC3 probe significantly reduced IOP in eyes with naive and refractory glaucoma but severe post-operative complications were often observed. Further studies are needed to better identify responders and decrease the high risk for complications associated with the procedure.

Klíčová slova:

Edema – Eyes – Glaucoma – Ophthalmic procedures – Retinal detachment – Surgical and invasive medical procedures – Trabeculectomy – Visual acuity


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