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Refractory open angle glaucoma treated by high intensity focused ultrasound (HIFU). Results at one year of a prospective series
Author(s) -
ROULAND J,
APTEL F
Publication year - 2014
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/j.1755-3768.2014.t042.x
Subject(s) - high intensity focused ultrasound , refractory (planetary science) , medicine , ophthalmology , open angle glaucoma , glaucoma , series (stratigraphy) , intensity (physics) , ultrasound , optometry , radiology , optics , materials science , geology , physics , paleontology , composite material
Purpose To assess the safety and efficacy of Ultrasound Circular Cyclo‐Coagulation (UC3 procedure) using HIFU (high intensity focused ultrasound) in patients with refractory open angle glaucoma. Methods Prospective clinical series performed in two centers, on twenty‐eight eyes of twenty‐eight patients with primary open‐angle glaucoma, treated with the EyeOP1 medical device equipped with six miniaturized cylindrical piezoelectric transducers. All eyes were treated with a 6‐second exposure time from each transducer. The main assessment criteria were safety and efficacy as indicated by the incidence of complications and by the IOP reduction. Ophthalmic, ultrasound biomicroscopy and flare examinations were performed before treatment and during clinical follow‐up at D1, D7, M1, M2, M3 M6 and M12 Results The mean intraocular pressure was significantly reduced from 29.0 ± 7.2 mmHg before treatment to 21.6 ± 9.4 mmHg at last follow‐up. Eight patients needed to be re‐treated. Complete success rate, as defined by an IOP reduction >20% and IOP> 5 mmHg after one UC3 procedure was 50%, and 68% after re‐treatments. The mean IOP reduction achieved in responding patients was 45%. No major intra‐ or post‐operative complications occurred. Clinical examination showed no lesions of the ocular structures other than the ciliary body and no or few signs of intraocular inflammation after treatment. Ocular inflammation evidenced by flare was very limited and non‐significant. Conclusion Coagulation of the ciliary body using high intensity focused ultrasound delivered by miniaturized transducers is a simple, well‐tolerated procedure which enables to significantly reduce the intraocular pressure in patients with refractory Open Angle Glaucoma.Commercial interest