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Objectives: To assess the efficacy and safety of ultrasound ciliary plasty (UCP) for treating refractory glaucoma during one year follow-up.
Material and methods: A total of 57 patients (37 F, 20 M; mean age: 67.6 years) with primary and secondary refractory glaucoma were enrolled to undergo UCP. The inclusion criteria for the study were: ≥ 18 years, uncontrolled open-angle glaucoma (IOP > 21 mmHg), contraindication to incisional glaucoma surgery, intolerance to glaucoma medications despite well-controlled IOP. The exclusion criteria were: pregnancy, age < 18 years, IOP > 30 mmHg, angle-closure glaucoma and neovascular glaucoma. Complete ophthalmic examinations were performed preoperatively and as well as 1 week and 1, 3, 6, 12 months postoperatively. An IOP reduction of 20% or > 5 mmHg as compared to the baseline value was considered as successful treatment. Complete success was defined as cessation of antiglaucoma medications.
Results: The mean IOP at the last follow-up was reduced by 26.9%. The success rate was 87.7% and the complete success rate was 12.3%. The mean ± SD values of the number of antiglaucoma medications were: 4.0 ± 0.9, 0.9 ± 1.1, 0.9 ± 1.1, 1.1 ± 1.1, 1.8 ± 1.4, 2.1 ± 1.4, 2.4 ± 1.4 (p < 0.001 for all values), respectively. The best-corrected logMAR visual acuities were: 0.37 ± 0.46, 0.47 ± 0.45 (p = 0.003), 0.46 ± 0.45 (p = 0.004), 0.31 ± 0.37 (p = 0.151), 0.36 ± 0.45 (p = 0.880), 0.39 ± 0.47 (p = 0.504), respectively. Following the procedure, choroid detachment was observed in three patients (5.3%) and macular in two patients (3.5%). No other major intraoperative or postoperative complications occurred.
Conclusion: Ultrasound ciliary plasty is a safe and well-tolerated procedure in medium-term follow-up. Further studies with a larger group of patients and longer follow-up are needed to confirm these results.
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