The effect of glaucoma treatment using high intensity focused ultrasound on total and corneal astigmatism: a prospective multicentre study
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First Author: R.Esteves Marques PORTUGAL
Co Author(s): D. Sousa E. Vandewalle A. Somers I. Stalmans L. Pinto
Ultrasound Cyclo Plasty (UCP) acts through the selective coagulation of the ciliary body using High-Intensity Focused Ultrasound (HIFU) technology. Our aim was to investigate if the application of ultrasound beams aiming at the ciliary body using an external probe influences astigmatism.
Subanalysis of a multicentric, prospective, single-arm, open-label trial conducted in in four countries (Belgium, Israel, Italy and Portugal).
Inclusion criteria: adult patients with primary open-angle glaucoma, with moderately uncontrolled intraocular pressure (IOP) under glaucoma medication. Primary outcome: induced corneal astigmatism, as calculated from topography, and statistically addressed through vector analysis. Secondary outcomes: induced total astigmatism, and mean change from baseline in best-corrected visual acuity (logMAR) and IOP. Subgroup analysis was performed to assess the impact of device centring on corneal and total induced astigmatism.
Fifty eyes were enrolled. Mean age was 69.6±11.3 years old. At 1, 3 and 6 months post-procedure, HIFU induced corneal astigmatism was 0.88D×93°, 0.87D×106° and 1.16D×97°, respectively, while induced total astigmatism was 0.62D×103°, 0.42×106°, and 0.39×107°. By the last follow-up, the percentage of patients under 0.5D, 1.00D, 1.50D and 2.00D of induced corneal vs. total astigmatism was 8.3% vs. 46%, 29% vs. 66%, 62.5% vs 88%, and 79% vs. 94%. Visual acuity was statistically significantly impaired by the first month, but no difference remained by the 3 and 6 months post-procedure.
UCP procedure is associated with increased corneal astigmatism. However, its impact in total refractive astigmatism is less pronounced.
... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented