Abstract
Purpose
The aim of the study is to study the safety and efficacy of three cyclodestructive treatments; high-intensity focused ultrasound (HIFU) cyclocoagulation versus micropulse cyclophotocoagulation (MP-CPC) versus transscleral continuous-wave cyclophotocoagulation (CW-CPC) for treatment of non-refractory glaucoma.
Methods
This is a prospective comparative single-center study. Thirty non-refractory, medically uncontrolled, primary open-angle glaucoma patients with good vision were randomized to a single session of HIFU, MP-CPC or CW-CPC. Intraocular pressure (IOP) reduction, number of medications, success rate, visual acuity and complications were compared between the three groups. Success was defined as an IOP reduction of 30% and IOP between 6 and 21 mmHg with or without medications, in the absence of vision-threatening complications.
Results
Thirty patients were enrolled in our study: 10 patients received HIFU, 10 patients received MP-CPC and 10 patients received CW-CPC. At 6 months, IOP was reduced by 31.5%, 23.9% and 19.4% (P = 0.4) achieving a success rate of 50%, 60% and 50% (P = 0.8) for continuous, micropulse and HFU groups, respectively, with reduction in the number of drops and stop of oral acetazolamide. Although the difference in the rate of complications between groups was not significant, CW-CPC group had more complications.
Conclusions
Cyclophotocoagulation could be an option in the treatment of non-refractory glaucoma even in patients with good visual acuity, with similar outcomes between the three types of cyclodestruction.
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ESH is operating and following up the patients and revising the manuscript. AA was involved in acquisition, analysis, interpretation of data for the work, drafting the work and revising.
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Informed consent was obtained from all the patients. This study followed the tenets of Declaration of Helsinki, and the study protocol was revised and approved by Ophthalmology Department ethical committee at Cairo University.
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Abdullatif, A.M., Ahmed El-Saied, H.M. Various modalities of cyclodestruction in non-refractory glaucoma: a comparative study. Int Ophthalmol 41, 3313–3323 (2021). https://doi.org/10.1007/s10792-021-01893-z
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DOI: https://doi.org/10.1007/s10792-021-01893-z