The effect of glaucoma treatment using high-intensity focused ultrasound on total and corneal astigmatism: a prospective multicentre study

Raquel Esteves Marques, David Cordeiro Sousa, Evelien Vandewalle, Alix Somers, Shlomo Melamed, Marco Nardi, Michele Figus, Ingeborg Stalmans, Luis Abegao Pinto

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Ultrasound cycloplasty (UCP) acts through the selective coagulation of the ciliary body using high-intensity focused ultrasound (HIFU) technology. The aim of this study was to investigate whether the application of ultrasound beams targeting the ciliary body using an external probe influences astigmatism. Methods: Multicentre, prospective, single-arm, open-label study in adult patients with primary open-angle glaucoma and moderately uncontrolled intraocular pressure (IOP) under glaucoma medication. The primary outcome was induced corneal astigmatism, calculated from topography, and assessed statistically through vector analysis. Secondary outcomes included induced total astigmatism and mean changes from baseline in best-corrected visual acuity (logMAR) and IOP. Subgroup analysis was performed to assess the impact of device centring on corneal and total induced astigmatism. Results: Fifty eyes were enrolled. Mean age was 69.6 ± 11.3 years. At 1, 3 and 6 months postprocedure, HIFU-induced corneal astigmatism was 0.88 D × 93°, 0.87 D × 106° and 1.16 D × 97°, respectively, while induced total astigmatism was 0.62 D × 103°, 0.42 × 106° and 0.39 × 107°. By the last follow-up, the percentage of patients with <0.50, <1.00, <1.50 and <2.00 D of induced corneal versus total astigmatism was 8.3% versus 46%, 29% versus 66%, 62.5% versus 88% and 79% versus 94%. Visual acuity was statistically significantly impaired at 1 month, but no difference remained by 3 and 6 months postprocedure. Conclusion: Ultrasound cycloplasty procedure is associated with increased corneal astigmatism. However, its impact on total refractive astigmatism is less pronounced.

Original languageEnglish
Pages (from-to)833-840
Number of pages8
JournalActa Ophthalmologica
Volume98
Issue number8
DOIs
StatePublished - Dec 2020

Keywords

  • astigmatism
  • ciliary body
  • glaucoma
  • high-intensity focused ultrasound
  • ocular hypertension
  • ultrasound cyclocoagulation

Fingerprint

Dive into the research topics of 'The effect of glaucoma treatment using high-intensity focused ultrasound on total and corneal astigmatism: a prospective multicentre study'. Together they form a unique fingerprint.

Cite this