Primary open angle glaucoma treated by high intensity focused ultrasound (HIFU) with the 2nd generation probe

Abstract

PurposeTo assess the safety and efficacy of Ultrasound Ciliary Plasty (UCP procedure) using HIFU (high intensity focused ultrasound) with a second‐generation probe which increases the treatment surface area and the firing duration in patients with primary open angle glaucoma.MethodsProspective clinical series performed in two University Hospitals, on eighteen eyes of eighteen patients with primary open‐angle glaucoma, treated with the EyeOP1 medical device equipped with six miniaturized cylindrical piezoelectric transducers of a new generation with an increased lesion volume. All eyes were treated with an 8‐second exposure time per transducer. The main assessment criteria were safety and efficacy measured by the incidence of complications and IOP reduction. Ophthalmic examination and ultrasound biomicroscopy were performed before treatment and during clinical follow‐up at D7, M1, M3, M6 and M12.ResultsThe mean intraocular pressure was significantly reduced from 28.4 ± 5.4 mmHg before treatment to 17.4 ± 3.8 mmHg at last follow‐up. Complete success rate, as defined by an IOP reduction >20% and IOP > 5 mmHg after one UCP procedure was 84%. The mean IOP reduction achieved in responding patients was 42%. No major intra‐ or post‐operative complications were observed. Clinical examination showed no lesions of ocular structures other than the ciliary body and no or few signs of intraocular inflammation after treatment.ConclusionsCoagulation of the ciliary body using high intensity focused ultrasound carried out with the new‐generation of miniaturized transducers is a simple, well‐tolerated procedure which enables to significantly reduce the intraocular pressure in patients with Open Angle Glaucoma.