Development of a Miniaturized HIFU Device for Glaucoma Treatment With Conformal Coagulation of the Ciliary Bodies

Charrel, Thomas; Aptel, Florent; Birer, Alain; Chavrier, F.; Romano, Fabrice; Chapelon, Jean‐Yves; Denis, Philippe; Lafon, Cyril

doi:10.1016/j.ultrasmedbio.2011.01.017

Cited by 61 publications

(52 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the use of cyclodestructive techniques is currently mainly limited to eyes with refractory glaucoma with poor or null visual acuity, due to the lack of selectivity for the targeted ciliary body, the unpredictable dose-effect relationship, and the high rate of complications [2,5,6]. In recent years, a novel device employing high-intensity focused ultrasound for the coagulation of the ciliary body (ultrasound cyclo-plasty; UCP) has been introduced, with the aim of achieving selective coagulation of the ciliary body while sparing the adjacent structures [7][8][9][10][11]. Here, we report the 1-year results of UCP procedures performed in 3 Italian glaucoma centres.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Cyclo-Plasty in Patients with Glaucoma: 1-Year Results from a Multicentre Prospective Study

et al. 2018

View full text Add to dashboard Cite

Purpose: The aim of this study was to evaluate the safety and efficacy of ultrasound cyclo-plasty (UCP) for reducing intraocular pressure (IOP) in patients with glaucoma. Methods: This is a multicentre prospective study conducted in 3 Italian glaucoma centres. UCP was performed by EyeOP1, which delivers ultrasound beams using 6 piezoelectric transducers activated for 4/6 s (first generation) or 8 s (second generation). Primary outcomes were the mean IOP reduction and the rates of success after 1 year. Secondary outcomes were the mean IOP reduction at each follow-up, and the reduction of the number of hypotensive medications. Results: In total, 49 eyes from 47 patients were treated. One year postoperatively, the mean IOP had decreased from 27.7 ± 9.2 to 19.8 ± 6.9 mm Hg (p < 0.001), and the mean number of hypotensive drops and tablets had decreased from 3.2 and 0.5 to 2.3 and 0.2, respectively (p < 0.05). Postoperative IOP reduction was significantly related to preoperative IOP (r² = 0.5034; p < 0.0001). Second-generation probes determined a significantly higher IOP reduction (p < 0.05). Qualified success was achieved in 25 eyes (51.1%) and complete success in 21 (42.9%), while failure was recorded in 12 (24.5%). Conclusions: UCP is safe and effective for reducing IOP. The procedure determines a greater IOP reduction in patients with higher preoperative IOP. Second-generation probes improve outcomes without detrimental effects on safety.

show abstract

Section: Introductionmentioning

confidence: 99%

Ultrasound Cyclo-Plasty in Patients with Glaucoma: 1-Year Results from a Multicentre Prospective Study

et al. 2018

View full text Add to dashboard Cite

show abstract

“…To overcome the drawbacks of the current and past methods of cyclodestruction and taking advantage of recent breakthroughs in the field of high-intensity focused ultrasound (HIFU) technology, a new device was recently developed, aiming to achieve a selective and precise coagulation of the ciliary body while sparing the adjacent ocular structures (Aptel et al 2010(Aptel et al , 2014aCharrel et al 2011;Aptel & Lafon 2012;Denis et al 2015). Experimental studies have shown a selective and circumferentially distributed coagulation necrosis of the treated ciliary processes and ciliary body (Aptel et al 2010(Aptel et al , 2014b.…”

Section: Introductionmentioning

confidence: 99%

Multicenter clinical trial of high‐intensity focused ultrasound treatment in glaucoma patients without previous filtering surgery

Aptel

Denis

Rouland

et al. 2015

Acta Ophthalmologica

Self Cite

View full text Add to dashboard Cite

ABSTRACT.Purpose: To evaluate the efficacy and safety of the ultrasonic circular cyclocoagulation procedure in patients with open-angle glaucoma na€ ıve of previous filtering surgery. Methods: Prospective non-comparative interventional clinical study conducted in five French University Hospitals. Thirty eyes of 30 patients with open-angle glaucoma, intra-ocular pressure (IOP) > 21 mmHg and with no previous filtering glaucoma surgeries were sonicated with a probe comprising six piezoelectric transducers. The six transducers were activated with a 6-s exposure time. Complete ophthalmic examinations were performed before the procedure and at 1 day, 1 week, 1, 2, 3, 6 and 12 months after the procedure. Primary outcomes were qualified surgical success (defined as IOP reduction from baseline ≥20% and IOP > 5 mmHg with possible re-intervention and without hypotensive medication adjunction) and complete surgical success (defined as IOP reduction from baseline ≥20%, IOP > 5 mmHg and IOP < 21 mmHg with possible re-intervention and without hypotensive medication adjunction) at the last follow-up visit and vision-threatening complications. Secondary outcomes were mean IOP at each follow-up visit compared with baseline, medication use, complications and re-interventions. Results: Intra-ocular pressure was significantly reduced (p < 0.05) from a mean pre-operative value of 28.2 AE 7.2 mmHg (n = 3.6 hypotensive medications) to 19.6 AE 7.9 mmHg at 12 months (n = 3.1 hypotensive medications and n = 1.1 procedures) (mean IOP reduction of 30%). Qualified success was achieved in 63% of eyes (19/30) (mean IOP reduction of 37% in these eyes) and complete success in 46.7% of eyes (14/30) (mean IOP reduction of 37% in these eyes) at the last follow-up. No major intra-or post-operative complications occurred. Conclusions: The UC 3 procedure seems to be an effective and well-tolerated method to reduce IOP in patients with open-angle glaucoma without previous filtering surgery.

show abstract

“…To overcome the drawbacks of the current and past methods of cyclodestruction, and taking advantage of recent breakthroughs in the field of high-intensity focused ultrasound (HIFU) technology, a new device was recently developed, the aim being to achieve a selective and precise destruction of the ciliary body, sparing the adjacent ocular structures [9][10][11][12] . In the first human pilot study designed to evaluate the feasibility and safety of the method, conducted in patients with refractory and very advanced secondary glaucoma (neovascular, congenital, uveitic, aphakic), twelve patients were enrolled and followed during at least 1 year 12 .…”

Section: Introductionmentioning

confidence: 99%

Treatment of refractory open-angle glaucoma using ultrasonic circular cyclocoagulation: a prospective case series

Aptel

Dupuy

Rouland

2014

Current Medical Research and Opinion

Self Cite

View full text Add to dashboard Cite

show abstract

Development of a Miniaturized HIFU Device for Glaucoma Treatment With Conformal Coagulation of the Ciliary Bodies

Cited by 61 publications

References 37 publications

Ultrasound Cyclo-Plasty in Patients with Glaucoma: 1-Year Results from a Multicentre Prospective Study

Ultrasound Cyclo-Plasty in Patients with Glaucoma: 1-Year Results from a Multicentre Prospective Study

Multicenter clinical trial of high‐intensity focused ultrasound treatment in glaucoma patients without previous filtering surgery

Treatment of refractory open-angle glaucoma using ultrasonic circular cyclocoagulation: a prospective case series

Contact Info

Product

Resources

About