Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Glaucoma Research Chair, King Saud University, Riyadh, Saud Arabia.
Semin Ophthalmol. 2023 Jul;38(5):482-489. doi: 10.1080/08820538.2023.2170715. Epub 2023 Feb 10.
To evaluate the 2-year outcomes of ultrasound cyclo plasty (UCP) as a first procedure in glaucoma.
This retrospective cohort study included patients with uncontrolled glaucoma who underwent UCP as an initial glaucoma procedure. The main outcome measures were intraocular pressure (IOP), the number of antiglaucoma medications, visual acuity, and the presence of vision-threatening complications. Surgical outcomes of each eye were classified as either complete success, qualified success, or failure based on the main outcome measures. Differences in IOP control and success rates were compared in eyes with primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG).
We included 98 eyes of 88 patients in the study. The mean follow-up period was 27.25 ± 10.1 months. At 12 and 24 months, mean IOP decreased significantly from 23.16 ± 6.4 mmHg to 16.57 ± 6.0 mmHg and 16.18 ± 5.2 mmHg, respectively, and the number of antiglaucoma medications decreased from 3.27 ± 0.9 to 1.86 ± 1.4 and 1.70 ± 1.7, respectively (p < .01 for all). There were no changes in visual acuity throughout the follow-up compared with preoperative levels. The cumulative probabilities of success were 64.3% (±4.8) [78.9% (±9.4) complete success, and 72.9% (±6.4) qualified success], and 42.9% (±5.0) [52.6% (±11.5) complete success, and 56.3% (±7.2) qualified success] at 12 and 24 months, respectively. The most common complications were cataract development/progression, anterior chamber inflammation, and macular edema. There were no significant differences in IOP, number of antiglaucoma medications, or survival rates between POAG and PACG groups.
UCP can be used as an initial glaucoma procedure for reducing IOP and the number of antiglaucoma medications and offers comparable outcomes in POAG and PACG.
评估超声睫状体成形术（UCP）作为青光眼初始治疗的 2 年疗效。
本回顾性队列研究纳入了接受 UCP 作为初始青光眼治疗的未控制青光眼患者。主要观察指标为眼内压（IOP）、抗青光眼药物的数量、视力和威胁视力的并发症。根据主要观察指标，将每只眼的手术结果分为完全成功、合格成功或失败。比较原发性开角型青光眼（POAG）和原发性闭角型青光眼（PACG）患者的 IOP 控制和成功率差异。
本研究纳入了 88 例患者的 98 只眼。平均随访时间为 27.25±10.1 个月。在 12 和 24 个月时，平均 IOP 分别从 23.16±6.4mmHg 显著下降至 16.57±6.0mmHg 和 16.18±5.2mmHg，抗青光眼药物的数量分别从 3.27±0.9 降至 1.86±1.4 和 1.70±1.7（所有比较均 p<0.01）。与术前相比，整个随访过程中视力没有变化。累计成功率为 64.3%（±4.8）[78.9%（±9.4）完全成功，72.9%（±6.4）合格成功]和 42.9%（±5.0）[52.6%（±11.5）完全成功，56.3%（±7.2）合格成功]，分别在 12 和 24 个月时。最常见的并发症是白内障进展/形成、前房炎症和黄斑水肿。POAG 和 PACG 组之间的 IOP、抗青光眼药物数量或生存率无显著差异。
UCP 可作为降低 IOP 和抗青光眼药物数量的初始青光眼治疗方法，在 POAG 和 PACG 中提供可比的结果。
