A Comparative Study of Ultrasound Cycloplasty and Endoscopic Cyclophotocoagulation in the Treatment of Secondary Glaucoma

Abstract

Abstract Purpose To compare the clinical efficacy of ultrasound cycloplasty (UCP) and endoscopic cyclophotocoagulation (ECP) in the treatment of secondary glaucoma. Methods A 12-month prospective single-center study included 23 patients with secondary glaucoma treated by high-intensity focused ultrasound (HIFU) and 20 patients with secondary glaucoma treated by a semiconductor laser. The primary outcome was evaluated by the surgical success at the last follow-up of the two groups (complete success constituted an intraocular pressure (IOP) reduction of ≥ 20% from the baseline and an IOP of > 5 mmHg and ≤ 21 mmHg, while qualified success was defined as an IOP reduction of ≥ 20% from the baseline and an IOP of > 5 mmHg). The secondary outcome was the average IOP, number of drugs, and complications at each follow-up compared with the baseline. Results The average preoperative IOPs in the UCP and ECP groups were 36.4 ± 9.5 mmHg (n = 2.3 drops, n = 0.2 tablets) and 34.5 ± 11.7 mmHg (n = 2.0 drops, n = 0.3 tablets), respectively. In the last follow-up, the success rate of UCP was 54% (with a decrease of 32%), and that of ECP was 65% (with a decrease of 35%), and the P-value between the two groups was > 0.05. However, there was a difference in the average IOP between the two groups one day and one week after the operation, and the effect of lowering IOP in the ECP group was better. However, the amount of drug use after the operation was significantly reduced. There were fewer postoperative complications in the UCP group (18 cases) than in the ECP group (35 cases). Conclusion Both UCP and ECP can effectively reduce IOP in secondary glaucoma, and ECP has a better effect in the early stages. However, UCP is safer and more tolerated.