Ultrasound Cyclo Plasty After Failed Glaucoma Surgery: Outcomes and Complications

Faisal A Almobarak; Ahmed Alrubean; Waleed K Alsarhani; Abdullah Aljenaidel; Essam Osman

doi:10.1007/s40123-022-00538-3

Ultrasound Cyclo Plasty After Failed Glaucoma Surgery: Outcomes and Complications

Ophthalmol Ther. 2022 Aug;11(4):1601-1610. doi: 10.1007/s40123-022-00538-3. Epub 2022 Jun 25.

Authors

Faisal A Almobarak^{1

2}, Ahmed Alrubean^{3

4}, Waleed K Alsarhani^{3

5

6}, Abdullah Aljenaidel³, Essam Osman^{3

7}

Affiliations

¹ Department of Ophthalmology, College of Medicine, King Saud University, P.O. Box 245, Riyadh, 11411, Saudi Arabia. falmobarak@ksu.edu.sa.
² Glaucoma Research Chair, King Saud University, Riyadh, Saudi Arabia. falmobarak@ksu.edu.sa.
³ Department of Ophthalmology, College of Medicine, King Saud University, P.O. Box 245, Riyadh, 11411, Saudi Arabia.
⁴ Department of Ophthalmology, College of Medicine, Al-Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia.
⁵ Department of Ophthalmology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
⁶ Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.
⁷ Glaucoma Research Chair, King Saud University, Riyadh, Saudi Arabia.

Abstract

Introduction: The purpose of this study is to report the outcomes and complications of ultrasound cyclo plasty (UCP) after failed glaucoma surgery.

Methods: A retrospective case series included patients with previously failed glaucoma surgery who underwent UCP at King Abdul Aziz University Hospital, Riyadh, Saudi Arabia, between 2016 and 2021. The main outcome measures were: intraocular pressure (IOP), number of antiglaucoma medications and presence of vision-threatening complications. The surgical outcome of each eye was based on the main outcome measures.

Results: Seventy eyes of 70 patients were included in the study. The mean follow-up period was 31.89 months (± 17.5). The IOP and the number of antiglaucoma medications decreased significantly from a mean of 23.91 mmHg (± 6.3) and 3.43 (± 0.8) to 17.88 mmHg (± 8.1) and 2.48 (± 1.3) and of 16.74 (± 7.9) and 2.11 (± 1.3) at the 12th and 24th months postoperatively, respectively (p < 0.01 for both). The success rates were 77.1% (54/70) and 48.6% (34/70), while the failure rates were 22.9% (16/70) and 2.9% (2/70) at the 12th and 24th months postoperatively, respectively. The cumulative probabilities of success were 70.0% (± 5.5%) and 47.1% (± 6.0%) at the 12th and 24th months postoperatively, respectively. The most common complications were anterior chamber reaction (24.3%), cataract development/progression (18.6%), hypotony/choroidal detachment (4.3%), phthisis bulbi (1.4%) and aqueous misdirection (1.4%).

Conclusions: UCP is an effective treatment modality to control IOP and decrease the burden of antiglaucoma medications in eyes with previously failed glaucoma surgery. Monitoring and counseling of possible postoperative complications are needed.

Keywords: Ciliary body; Cyclo-coagulation; Filtering surgery; Glaucoma; Glaucoma surgery; High-intensity focused ultrasound; Intraocular pressure; Ultrasound cyclo plasty.