Department of Surgical, Medical, Molecular Pathology and of Critical Area, University of Pisa, Pisa, Italy.
Eye Clinic, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy.
Surv Ophthalmol. 2019 Nov-Dec;64(6):826-834. doi: 10.1016/j.survophthal.2019.05.001. Epub 2019 May 22.
Glaucoma, one of the leading causes of blindness, is usually first managed medically, with incisional surgery as a second step. Noninvasive glaucoma procedures attempt to fill the gap between medical and surgical treatments and may work synergistically with them. High-intensity focused ultrasound induces a selective and controlled thermal ablation of the distal part of the ciliary body, and this effect is independent from the degree of tissue pigmentation with limited damage to adjacent structures. This selective and innovative treatment decreases intraocular pressure by reducing aqueous humor production and by increasing uveoscleral outflow. We review the current literature on the use of high-intensity focused ultrasound in glaucoma, exploring present use, safety, efficacy, and future clinical applications.
青光眼是导致失明的主要原因之一,通常首先通过医学手段进行治疗,手术作为第二步治疗手段。非侵入性青光眼手术旨在填补医学和手术治疗之间的空白,并可能与它们协同作用。高强度聚焦超声可选择性地、控制性地对睫状体的远端进行热消融,这种效果与组织色素沉着程度无关,对邻近结构的损伤有限。这种选择性和创新性的治疗方法通过减少房水的产生和增加葡萄膜巩膜外流来降低眼压。我们回顾了高强度聚焦超声在青光眼治疗中的应用的现有文献,探讨了其目前的应用、安全性、疗效和未来的临床应用。