Using Ultrasound Cyclo-Plasty as A Preventive Glaucoma Treatment for Eyes Undergoing Boston Keratoprosthesis Type I Implantation

Abstract

Purpose: To study the benefit of performing Ultrasound Cyclo-Plasty (UCP) using High-Intensity Focused Ultrasound (HIFU) as a glaucoma treatment in eyes undergoing Boston kerato-prosthesis type I and to evaluate the control of intraocular pressure and glaucoma progression postoperatively.

Methods: This is a retrospective study review of cases that underwent Boston Kerato-prosthesis type 1 implantation with UCP treatment at the same time in Ocular Hypertension (OHT), glaucoma suspects or glaucoma patients.

Results: Fourteen patients (14) underwent a BKpro implant combined with UCP procedure. Mean age 53,2 ± 20 years (range 26 to 81 years). 10 males and 4 females, 5 right eyes and 9 left eyes. The average duration of follow-up was 36 months (range 6 to 70 months). Mean IOP was reduced from 21.7 ± 6.6 mm Hg to 15.86 ±4.02 which was sustained in longer follow up periods 15.1 ± 4.3. at the last visit, corresponding to a mean IOP reduction of 23%. Only two patients required further glaucoma surgical intervention. Vision improved to better than 20/80 in five patients, better than 20/200 in two and four remained unchanged in the 20/200-20/400 vision group and two patients had worsening of vision.

Conclusions: For a mean follow-up of 3 years and ranging up to more than 5 years, the glaucoma progression or the conversion from Glaucoma Suspect (OHT) into a Glaucoma according to our criteria and definition, was only seen in 1 case (7,14%). The complications cannot be associated with the UCP treatment and might be related to the BKpro + UCP surgery itself. UCP, in combination of BKpro, seems to be a safe procedure to slow down the progression of glaucoma in cases undergoing BKpro.