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.

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Comparison of Ultrasound Cycloplasty and Transscleral Cyclophotocoagulation for Refractory Glaucoma in Chinese Population

10.21203/rs.3.rs-20555/v3 ◽

2020 ◽

Author(s):

Qiuli Yu ◽

Ya Liang ◽

Fangfang Ji ◽

Zhilan Yuan

Keyword(s):

Visual Acuity ◽

Chinese Population ◽

Baseline Level ◽

Focused Ultrasound ◽

Efficacy And Safety ◽

Refractory Glaucoma ◽

Corrected Visual Acuity ◽

Transscleral Cyclophotocoagulation ◽

Time Point

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 retrospective 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.

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Comparison of Ultrasound Cycloplasty and Transscleral Cyclophotocoagulation for Refractory Glaucoma in Chinese Population

10.21203/rs.3.rs-20555/v1 ◽

2020 ◽

Author(s):

Qiuli Yu ◽

Ya Liang ◽

Fangfang Ji ◽

Zhilan Yuan

Keyword(s):

Visual Acuity ◽

Chinese Population ◽

Baseline Level ◽

Focused Ultrasound ◽

Efficacy And Safety ◽

Refractory Glaucoma ◽

Corrected Visual Acuity ◽

Transscleral Cyclophotocoagulation ◽

Time Point

Abstract Background: To compare the efficacy and safety of focused ultrasound cycloplasty (UCP) and transscleral cyclophotocoagulation (TSCP) in the treatment of refractory glaucoma in Chinese population. Methods: We retrospective compared twenty-eight eligible patients with refractory glaucoma, who were divided into the UCP group and TSCP group. Patients in this two groups underwent a corresponding procedure during June 2018 to February 2019. The intraocular pressure (IOP), visual acuity, use of anti-glaucoma agents and complications were reviewed and compared between the two groups. Results: After the 12-months follow-up, postoperative IOP and number of anti-glaucoma agents, which were used postoperatively in the two groups were both lower 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 1d after surgery in the UCP group was significantly milder than that in the TSCP group (P<0.05), while 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.

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Comparison of Ultrasound Cycloplasty and Transscleral Cyclophotocoagulation for Refractory Glaucoma in Chinese Population

10.21203/rs.3.rs-20555/v4 ◽

2020 ◽

Author(s):

Qiuli Yu ◽

Ya Liang ◽

Fangfang Ji ◽

Zhilan Yuan

Keyword(s):

Visual Acuity ◽

Chinese Population ◽

Baseline Level ◽

Focused Ultrasound ◽

Efficacy And Safety ◽

Refractory Glaucoma ◽

Corrected Visual Acuity ◽

Transscleral Cyclophotocoagulation ◽

Time Point

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 retrospective 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.

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Comparison of Ultrasound Cycloplasty and Transscleral Cyclophotocoagulation for Refractory Glaucoma in Chinese Population

10.21203/rs.3.rs-20555/v2 ◽

2020 ◽

Author(s):

Qiuli Yu ◽

Ya Liang ◽

Fangfang Ji ◽

Zhilan Yuan

Keyword(s):

Visual Acuity ◽

Chinese Population ◽

Baseline Level ◽

Focused Ultrasound ◽

Efficacy And Safety ◽

Refractory Glaucoma ◽

Corrected Visual Acuity ◽

Transscleral Cyclophotocoagulation ◽

Time Point

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 retrospective 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.

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Transient choroidal detachment after ultrasonic circular cyclocoagulation

BMJ Case Reports ◽

10.1136/bcr-2019-231677 ◽

2019 ◽

Vol 12 (10) ◽

pp. e231677

Author(s):

Tiago Morais Sarmento ◽

Ricardo Figueiredo ◽

João Garrido ◽

Ana Luisa Rebelo

Keyword(s):

Visual Acuity ◽

Best Practice ◽

Choroidal Detachment ◽

Refractory Glaucoma ◽

Corrected Visual Acuity ◽

Retrobulbar Anaesthesia ◽

Oral Steroids ◽

Hypotensive Therapy ◽

Best Corrected Visual Acuity

Two patients with refractory glaucoma followed in our ophthalmology department registered progression on left eyes (OS) despite best practice. Best corrected visual acuity (BCVA) was 9/10 and 8/10 and intraocular pressure (IOP) was above 20 mm Hg while under maximal hypotensive therapy. The procedure was performed under retrobulbar anaesthesia with second-generation EyeOp1probes. In follow-up, OS were hypotonic with registered IOP ≤5 mm Hg and revealed a 3/10 BCVA. The funduscopy showed one temporal and superior and another nasal and temporal choroidal detachments. The patients started oral steroids and interrupted all ocular hypotensive medication. After therapy, patients returned with normal rising OS IOPs and with totally reapplied choroids, accompanied by normalised BCVA. These two cases are proof of the possibility of transient choroidal detachment after a ultrasonic circular cyclocoagulation. While a very rare major vision-threatening complication, every ophthalmologist should remind it when sudden BCVA reductions occur after this procedure.

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Micropulse transscleral cyclophotocoagulation using a standard protocol in patients with refractory glaucoma naive of cyclodestruction

European Journal of Ophthalmology ◽

10.1177/1120672119877586 ◽

2019 ◽

pp. 112067211987758 ◽

Cited By ~ 3

Author(s):

Soufiane Souissi ◽

Christophe Baudouin ◽

Antoine Labbé ◽

Pascale Hamard

Keyword(s):

Intraocular Pressure ◽

Diode Laser ◽

Glaucoma Surgery ◽

Refractory Glaucoma ◽

Corrected Visual Acuity ◽

Pressure Lowering ◽

Transscleral Cyclophotocoagulation ◽

The Mean ◽

Diode Laser Cyclophotocoagulation

Purpose: To assess the efficacy and safety of a standardized micropulse transscleral diode laser cyclophotocoagulation procedure in refractory glaucoma. Methods: Retrospective, interventional study in a series of 37 consecutive patients with refractory glaucoma, cyclodestructive procedure-naive, who underwent micropulse transscleral diode laser cyclophotocoagulation from December 2016 to October 2017. A successful laser treatment was defined as (1) intraocular pressure between 6 and 18 mm Hg; (2) 20% of baseline intraocular pressure reduction; (3) no additional glaucoma medications; (4) no decrease in vision due to complications or change in intraocular pressure; and (5) no need for additional glaucoma surgery except micropulse transscleral diode laser cyclophotocoagulation retreatment. Results: Mean age was 60.2 years. Mean follow-up was 9.7 ± 3.9 months. The mean preoperative intraocular pressure (28.7 mm Hg) significantly decreased to 21.0 mm Hg at 1 month, 18.5 mm Hg at 3 months, 18.4 mm Hg at 6 months, and 18.5 mm Hg at 12 months ( p < 0.01 at all time points). The mean number of preoperative glaucoma medications (4.7) decreased to 4.0 at 1 month ( p = 0.14), 4.5 at 3 months ( p < 0.05), 3.9 at 6 months ( p < 0.05), and 3.6 at 12 months ( p < 0.05). At 1 year, the success rate was 35% with a mean intraocular pressure lowering of 36%. One patient had hypotony and a loss of best-corrected visual acuity. Mild transient postoperative inflammation was observed in 8% of the cases. Conclusion: Using a standardized procedure, micropulse transscleral diode laser cyclophotocoagulation allows a mild intraocular pressure decrease with a low rate of complications and thus achieves a relatively good profit risk benefit, mostly for moderately hypertensive refractory glaucoma.

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Comparison of outcomes between Aurolab aqueous drainage implant placed in the superotemporal versus inferonasal quadrant

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-315558 ◽

2020 ◽

pp. bjophthalmol-2019-315558

Author(s):

George Varghese Puthuran ◽

Paul Frederic Palmberg ◽

Hiruni Kaushalya Wijesinghe ◽

Thandra Sai Shreya ◽

S R Krishnadas ◽

...

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Light Perception ◽

Refractory Glaucoma ◽

Significant Drop ◽

Time Points ◽

Corrected Visual Acuity ◽

Surgical Option ◽

Best Corrected Visual Acuity

AimTo determine the outcomes of Aurolab aqueous drainage implant (AADI) placed in the superotemporal versus the inferonasal quadrant in adult eyes with refractory glaucoma.MethodsThis was a retrospective study of eyes that had AADI placement and completed a minimum of 2-year follow-up. The choice of the quadrant was at the surgeon’s discretion and mainly depended on the amount of scarring and conjunctival mobility. The cumulative failure rate of the AADI was defined as intraocular pressure (IOP) >21 mm Hg or not reduced by 20% below baseline on two consecutive follow-up visits after 3 months, IOP ≤5 mm Hg on two consecutive follow-up visits after 3 months, reoperation for glaucoma or a complication, or loss of light perception vision.ResultsWe included 84 eyes with AADI in the inferonasal quadrant versus 69 eyes in the superotemporal quadrant. A significant drop in IOP was seen in both groups (18.4±10.4 mm Hg in the inferonasal group vs 17.7±11.1 mm Hg in the superotemporal group; p=0.63) at 3-month follow-up and this was maintained until last follow-up. Best-corrected visual acuity, IOP, number of IOP-lowering medications and complications were similar between the two groups at all time points. The cumulative success rate at 2-year follow-up without IOP-lowering medications was 57.1% (47.1%–68.1%) in the inferonasal group and 50.7% (39.8%–63.1%) in the superotemporal group (p=0.47).ConclusionsInferonasal AADI placement appears to be an equally safe and effective surgical option compared with superotemporal AADI placement and may be helpful in certain clinical situations.

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Intermediate-term outcomes of Aurolab aqueous drainage implant in refractory paediatric glaucoma

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-314399 ◽

2019 ◽

Vol 104 (7) ◽

pp. 962-966 ◽

Cited By ~ 5

Author(s):

George Varghese Puthuran ◽

Paul Frederic Palmberg ◽

Hiruni Kaushalya Wijesinghe ◽

Srilekha Pallamparthy ◽

SR Krishnadas ◽

...

Keyword(s):

Visual Acuity ◽

Probability Of Failure ◽

Common Type ◽

Congenital Glaucoma ◽

Cumulative Probability ◽

Light Perception ◽

Refractory Glaucoma ◽

Time Point

AimTo report the intermediate-term outcomes of Aurolab aqueous drainage implant (AADI) surgery in paediatric eyes with refractory glaucoma.MethodsCase records of patients below 18 years, who underwent AADI surgery between 2012 and 2015 with >2 years follow-up, were analysed. The intraocular pressure (IOP), visual acuity, number of antiglaucoma medications, complications and resurgery if any were recorded at baseline, day 1and then at months 1, 3, 6, 9, 12, 18, 24 and at the last visit. Failure was defined as IOP >18 mm Hg or not reduced by at least 30% below baseline, IOP ≤5 mm Hg on two consecutive follow-up visits after 3 months, reoperation for a complication or loss of light perception vision.Results101 eyes of 101 patients were included with a mean age of 10.4±4.7 years at the time of surgery and a mean follow-up of 40.9±15.1 months. Glaucoma following cataract surgery was the most common type of glaucoma (n=31, 30%), followed by primary congenital glaucoma (n=29, 29%). The cumulative probability of failure was 15.8% (95% CI 10.1% to 24.5%) at 1 year, 22.7% (95% CI 15.7% to 32.2%) at 2 years, 42.5% (95% CI 32.6% to 53.9%) at 3 years and 62.1% (95% CI 49.5% to 74.8%) at the 4 years time point.ConclusionThe AADI showed excellent success until 2 years after surgery in paediatric eyes after which failure rates increased. Further prospective studies with longer follow-up are required to evaluate the long-term success of the AADI for paediatric glaucomas.

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Phacoemulsification combined with micropulse cyclodiode laser in glaucoma patients: efficacy and safety

Eye ◽

10.1038/s41433-021-01826-1 ◽

2021 ◽

Author(s):

Arij Daas ◽

Thomas Sherman ◽

Lina Danieliute ◽

Saurabh Goyal ◽

Andrew Amon ◽

...

Keyword(s):

Cataract Surgery ◽

Case Note ◽

Efficacy And Safety ◽

Retrospective Case ◽

Safety And Efficacy ◽

Time Points ◽

Transscleral Cyclophotocoagulation ◽

Case Note Review ◽

Time Point

Abstract Objective To evaluate the safety and efficacy of phacoemulsification combined with Micropulse transscleral cyclophotocoagulation (MP-TSCPC) in glaucoma patients. Methods This is a retrospective case-note review. The participants were adult patients with diagnoses of glaucoma and cataract who required a further reduction in IOP or a reduction in the number of glaucoma drops. All consecutive patients who underwent cataract surgery (CS) combined with MP-TSCPC laser between October 2018 and July 2019 were included in the study. The effect on visual acuity (VA), intraocular pressure (IOP) and number of anti-glaucoma drops were evaluated at 6 and 12 months in addition to any complications that occurred during any time point of the study. Results 42 eyes were included in the study. Mean IOP was reduced from 19.5 ± 5.4 mmHg by 22.5% to 15.1 ± 4.6 at 6 months post-operatively and by 19.5% to 15 ± 6.6 mm Hg at 12 months (p < 0.001 at both time points). The number of anti-glaucoma medications also reduced significantly from 2.8 ± 1.3 to 1.6 ± 1.2 at 6 months and to 2.2 ± 1.3 at 12 months (p < 0.001 at both time points). The success rate was 56% at 6 months and 54% at 12 months. 54.7% of our patients who completed 12 months follow up had an improvement or unchanged vision at the last visits. Conclusion This is the first study evaluating the effect of cataract surgery combined with MP-TSCPC in glaucoma patients. We demonstrated that this led to a reduction in IOP and the number of anti-glaucoma medications at 6 and 12-month postoperatively. The majority of patients had either stable or better vision at 12 months follow-up.

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Transepithelial High Fluence Crosslinking for Keratoconus – Case Report of 1-year Follow-up

European Ophthalmic Review ◽

10.17925/eor.2015.09.01.21 ◽

2015 ◽

Vol 09 (01) ◽

pp. 21

Author(s):

Roberto Pinelli ◽

Zahran Yazan Amin ◽

◽

Keyword(s):

Visual Acuity ◽

Case Report ◽

Corneal Topography ◽

High Fluence ◽

Efficacy And Safety ◽

Corrected Visual Acuity ◽

Uncorrected Visual Acuity ◽

Best Corrected Visual Acuity

Purpose:To evaluate the efficacy and safety of transepithelial crosslinking for halting the progression of keratoconus.Methods:Uncorrected and corrected visual acuity, simulated keratometry, corneal topography and pachymetry data were evaluated at baseline and 1 year after bilateral transepithelial crosslinking using ParaCel™ and the KXL™ device (Avedro, Waltham, Massachusetts, US).Results:The keratometry, uncorrected visual acuity, best corrected visual acuity at the baseline and after 1 year of follow-up was stable and even improved with time.Conclusion:Transepithelial crosslinking can safely and effectively halt the progression of keratoconus as demonstrated by follow-up.

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