Noninvasive glaucoma procedures (NIGPS) represent a new dawn in the management of glaucoma, as they try to fill the gap between the shortcoming of glaucoma surgeries and antiglaucoma medications.1
High-intensity focused ultrasound (HIFU) cyclocoagulation is a NIGPS that was introduced in the 1980s by Coleman et al. to selectively destroy ciliary body tissue and reduce aqueous humour production.2-4
Recently, the development of a new circular cyclocoagulation device, which uses miniaturised transducers to produce HIFU (EyeOP1 EyeTechCare, Rillieux-la-Pape, France), has renewed interest in the technique (see Figure 1).5,6 The procedure can also be defined as ultrasound ciliary plasty (UCP).
Parameters used are: 21 MHz operating frequency; six activated sectors; 2 to 3 W acoustic power; 8 seconds of the HIFU delivery time for each sector; and three different probe sizes (11-, 12- or 13-mm ring diameters) selected for each eye using preoperative biometric data based on AS-OCT image.7
Clinical trials in humans have shown that the device allowed a significant and predictable IOP reduction with a good local tolerance after one UCP treatment.5-8
In this study we aimed to evaluate success rate, long-term effectiveness and safety of multiple UCPs (up to three times per eye) in patients who experienced a lack of efficacy or incomplete success with prior glaucoma therapies.