High-Intensity Focused Ultrasound Circular Cyclocoagulation in Glaucoma: A Step Forward for Cyclodestruction?

Journal of Ophthalmology
Rodolfo MastropasquaLuca Agnifili

Abstract

The ciliary body ablation is still considered as a last resort treatment to reduce the intraocular pressure (IOP) in uncontrolled glaucoma. Several ablation techniques have been proposed over the years, all presenting a high rate of complications, nonselectivity for the target organ, and unpredictable dose-effect relationship. These drawbacks limited the application of cyclodestructive procedures almost exclusively to refractory glaucoma. High-intensity focused ultrasound (HIFU), proposed in the early 1980s and later abandoned because of the complexity and side effects of the procedure, was recently reconsidered in a new approach to destroy the ciliary body. Ultrasound circular cyclocoagulation (UC(3)), by using miniaturized transducers embedded in a dedicated circular-shaped device, permits to selectively treat the ciliary body in a one-step, computer-assisted, and non-operator-dependent procedure. UC(3) shows a high level of safety along with a predictable and sustained IOP reduction in patients with refractory glaucoma. Because of this, the indication of UC(3) was recently extended also to naïve-to-surgery patients, thus reconsidering the role and timing of ciliary body ablation in the surgical management of glaucoma. This a...Continue Reading

Associated Clinical Trials

Jun 12, 2020·Ameera Gamal Abdelhameed

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Citations

Oct 20, 2019·BMJ Case Reports·Tiago Morais SarmentoAna Luisa Rebelo
Nov 24, 2020·European Journal of Ophthalmology·Zhou LongfangPan Xiaojing
Apr 22, 2021·International Ophthalmology·Tiago Morais SarmentoAugusto Candeias

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Methods Mentioned

BETA
imaging techniques
scanning electron microscopy
confocal microscopy

Software Mentioned

Sonocare

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