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The effect of glaucoma treatment using high‐intensity focused ultrasound on total and corneal astigmatism: a prospective multicentre study
Author(s) -
Marques Raquel Esteves,
Sousa David Cordeiro,
Vandewalle Evelien,
Somers Alix,
Melamed Shlomo,
Nardi Marco,
Figus Michele,
Stalmans Ingeborg,
Abegao Pinto Luis
Publication year - 2020
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.14467
Subject(s) - medicine , ophthalmology , astigmatism , glaucoma , prospective cohort study , intraocular pressure , ciliary body , ultrasound , visual acuity , cornea , surgery , physics , radiology , optics
Abstract Purpose Ultrasound cycloplasty (UCP) acts through the selective coagulation of the ciliary body using high‐intensity focused ultrasound (HIFU) technology. The aim of this study was to investigate whether the application of ultrasound beams targeting the ciliary body using an external probe influences astigmatism. Methods Multicentre, prospective, single‐arm, open‐label study in adult patients with primary open‐angle glaucoma and moderately uncontrolled intraocular pressure (IOP) under glaucoma medication. The primary outcome was induced corneal astigmatism, calculated from topography, and assessed statistically through vector analysis. Secondary outcomes included induced total astigmatism and mean changes from baseline in best‐corrected visual acuity (logMAR) and IOP. Subgroup analysis was performed to assess the impact of device centring on corneal and total induced astigmatism. Results Fifty eyes were enrolled. Mean age was 69.6 ± 11.3 years. At 1, 3 and 6 months postprocedure, HIFU‐induced corneal astigmatism was 0.88 D × 93°, 0.87 D × 106° and 1.16 D × 97°, respectively, while induced total astigmatism was 0.62 D × 103°, 0.42 × 106° and 0.39 × 107°. By the last follow‐up, the percentage of patients with <0.50, <1.00, <1.50 and <2.00 D of induced corneal versus total astigmatism was 8.3% versus 46%, 29% versus 66%, 62.5% versus 88% and 79% versus 94%. Visual acuity was statistically significantly impaired at 1 month, but no difference remained by 3 and 6 months postprocedure. Conclusion Ultrasound cycloplasty procedure is associated with increased corneal astigmatism. However, its impact on total refractive astigmatism is less pronounced.