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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        

Abstract Details

Purpose:

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.

Setting:

Subanalysis of a multicentric, prospective, single-arm, open-label trial conducted in in four countries (Belgium, Israel, Italy and Portugal).

Methods:

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.

Results:

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.

Conclusions:

UCP procedure is associated with increased corneal astigmatism. However, its impact in total refractive astigmatism is less pronounced.

Financial Disclosure:

... 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