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

Aptel, Florent; Dupuy, Caroline; Rouland, Jean‐François

doi:10.1185/03007995.2014.910509

Cited by 53 publications

(56 citation statements)

References 11 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the second multicenter study, no other major intra-operative or postoperative complications occurred (Aptel et al 2014a). None of the patients had IOP spikes or major IOP increases in the early follow-up.…”

Section: Tolerance and Safetymentioning

confidence: 83%

“…In the second multicenter study conducted in 28 patients with primary open-angle glaucoma, all patients were treated with a 6-s exposure time and followed for at least 6 months (Aptel et al 2014a). IOP was significantly reduced (p < 0.05), from a mean preoperative value of 29.0 AE 7.2 mmHg to a mean value of 21.6 AE 9.4 mmHg at last follow-up (mean IOP reduction, 26%).…”

Section: Efficacymentioning

confidence: 99%

“…Some patients with an IOP response insufficient to reach the target intraocular pressure were retreated in both multicenter studies (Aptel et al 2014a;Denis et al 2015). The six transducers were activated, and the orientation of the device was unchanged (no rotation).…”

Section: Retreatmentmentioning

confidence: 99%

“…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%

“…The first one was a pilot study mainly designed to evaluate the feasibility and safety of the new method in a small number of eyes with refractory and very advanced glaucoma ). The two other studies were multicenter studies designed to evaluate the efficacy and safety of the method in eyes with open-angle glaucoma and less advanced disease than those treated in the pilot study, but still refractory to conventional surgery (at least one previous failed filtering surgery) (Aptel et al 2014a;Denis et al 2015). As these three studies have demonstrated that the method is well tolerated, particularly with no IOP spikes or major IOP increases in the early follow-up and, over the long term, no cases of severe hypotony or phthisis, some of the most serious adverse effects of the currently available cyclodestructive methods, a subsequent study was designed and conducted to evaluate the efficacy and safety of ultrasonic circular cyclocoagulation in patients with early glaucoma na€ ıve of any previous filtering surgery.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

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

Section: Tolerance and Safetymentioning

confidence: 83%

Section: Efficacymentioning

confidence: 99%

Section: Retreatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

show abstract

Cycloablation

Liebenthal¹,

Kahook

Noecker

et al. 2022

Albert and Jakobiec's Principles and Practice of Ophthalmology

View full text Add to dashboard Cite

HIFU Tissue Ablation: Concept and Devices

Haar

2016

Advances in Experimental Medicine and Biology

102

View full text Add to dashboard Cite

High intensity focused ultrasound (HIFU) is rapidly gaining clinical acceptance as a technique capable of providing non-invasive heating and ablation for a wide range of applications. Usually requiring only a single session, treatments are often conducted as day case procedures, with the patient either fully conscious, lightly sedated or under light general anesthesia. HIFU scores over other thermal ablation techniques because of the lack of necessity for the transcutaneous insertion of probes into the target tissue. Sources placed either outside the body (for treatment of tumors or abnormalities of the liver, kidney, breast, uterus, pancreas brain and bone), or in the rectum (for treatment of the prostate), provide rapid heating of a target tissue volume, the highly focused nature of the field leaving tissue in the ultrasound propagation path relatively unaffected. Numerous extra-corporeal, transrectal and interstitial devices have been designed to optimize application-specific treatment delivery for the wide-ranging areas of application that are now being explored with HIFU. Their principle of operation is described here, and an overview of their design principles is given.

show abstract

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

Abstract: UC(3) procedure seems to be an effective and well tolerated method to reduce intraocular pressure in patients with primary open-angle glaucoma. Studies directly comparing the efficacy and safety of the UC(3) procedure with that of trabeculectomy or diode laser are needed.

Cited by 53 publications

References 11 publications

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

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

Cycloablation

HIFU Tissue Ablation: Concept and Devices

Contact Info

Product

Resources

About