Clinical Efficacy of Ultrasound Cycloplasty for Glaucoma Patients and Pathological Observation on the Ciliary Body in Rabbit Models.

PURPOSE: To evaluate the efficacy and safety of ultrasound cycloplasty (UCP) for glaucoma patients and the ciliary body in rabbit models.

METHODS

A prospective case series clinical trial and a animal experiment were carried out separately. For human subjects, 55 patients (55 eyes) with refractory glaucoma underwent UCP. The preoperative and postoperative intraocular pressure (IOP), number of antiglaucoma medications, relevant parameters for measuring the ciliary body after UCP, ocular pain grade, and rate of surgical complications were recorded. For animal subjects, eighteen pigmented rabbits were subjected to UCP, and histological changes were observed under light microscopy and transmission electron microscopy 3 months after surgery.

RESULTS

The mean IOP was 45.05 ± 12.29 mmHg before surgery and 23.30 ± 10.00 mmHg 1 year after surgery, the mean number of antiglaucoma medications used was 3 (2, 3) before surgery and 1 (1, 2) 1 year after surgery, and The Visual Analog Scale score was 5 (4, 6) before surgery and 1(1, 2) 1 year after surgery (both p < 0.05). Ultrasound biomicroscopy revealed that the height of the ciliary processes (T value) at 6:00 and 12:00 had increased on Postoperative Day 1, recovered at 1 month after surgery, and decreased at 3 months after surgery for 20 patients. In the animal models, light microscopy revealed that part of the nonpigmented epithelium of the ciliary body had disappeared, the arrangement of the pigmented epithelium was disordered, and the stroma was edematous. Transmission electron microscopy revealed that the mitochondria were damaged and swollen and that the crista structure had dissolved and disappeared.

CONCLUSIONS

UCP is effective and safe for refractory glaucoma and requires a long follow-up time. It can effectively decrease IOP in glaucoma patients, reduce number of antiglaucoma medications, relief the pain, and has fewer complications. Trial Registration: Chinese Clinical Trial Register (ChiCTR): ChiCTR2500114521.