Comparison of ultrasound cycloplasty and transscleral cyclophotocoagulation for refractory glaucoma in Chinese population

Abstract

Background To compare the efficacy and safety of focused ultrasound cycloplasty (UCP) and transscleral cyclophotocoagulation (TSCP) in the treatment of refractory glaucoma in a Chinese population. Methods We retrospectively compared twenty-eight eligible patients with refractory glaucoma, who were divided into the UCP group and TSCP group. Patients in these two groups underwent a corresponding procedure from June 2018 to February 2019. The intraocular pressure (IOP), visual acuity, the number of anti-glaucoma agents used and complications were reviewed and compared between groups. Proper statistical methods were selected according to comparison models under IBM SPSS 25 software. Results After the 12-months follow-up, postoperative IOP and number of anti-glaucoma agents used in the two groups were both reduced than the baseline level, and the differences were statistically significant (P < 0.05). There were no significant differences in IOP, number of anti-glaucoma agents and the best-corrected visual acuity between the two groups at each follow-up time point (P>0.05). In terms of complications, the pain at 1 day after surgery in the UCP group was significantly milder than that in the TSCP group (P < 0.05). And there were no significant differences in other complications between the two groups (P > 0.05). Conclusions Both UCP and TSCP are safe and effective methods for the treatment of refractory glaucoma. Nevertheless, pain is less severe after UCP.

Efficacy and safety of high-intensity focused ultrasound cyclo-plasty in glaucoma

“…Reduction of aqueous humour secretion is the leading cause of decreased IOP. Several studies described a significant decrease in IOP from 1 day to 6 months after UCP [ 8 , 10 – 15 ]. Some studies found that IOP decreased during the 12 months after UCP [ 16 – 19 ].…”

“…Zhou et al found a 42%-92% success rate at 12 months postprocedure [ 8 ]. Figus et al and Wang et al described a more than 70% success rate at 24 months after UCP [ 10 , 21 ]. Leshno et al found an 87% success rate at 24 months after UCP [ 22 ].…”

“…Other mild complications included anterior chamber reaction, subconjunctival haemorrhage, superficial punctate keratitis, mydriasis, posterior synechiae, focal scleral thinning, and scleral marks. More severe complications, such as hyphema, transient hypotony, choroidal detachment, and macular oedema, have also been reported [ 4 , 10 , 13 , 19 ]. Wang et al reported that phthisis bulbi, a severe complication, occurred in 1 patient after UCP [ 12 ].…”

“…UCP procedure has been highlighted in glaucoma research in Europe and India in past 5-10 years. A few reports were found among Chinese patients and UCP was just only applicated in refractive glaucoma or end stage glaucoma (with very low vision, such as less than counting finger) [ 5 – 10 ]. Few studied were performed BCVA comparison before and after UCP surgery [ 7 , 10 ].…”

“…A few reports were found among Chinese patients and UCP was just only applicated in refractive glaucoma or end stage glaucoma (with very low vision, such as less than counting finger) [ 5 – 10 ]. Few studied were performed BCVA comparison before and after UCP surgery [ 7 , 10 ]. The efficacy and safety need to be investigated among Chinese glaucoma patients with better vision other than in end stage glaucoma.…”