The Influence of Ultrasound Ciliary Plasty on Corneal Parameters

Precis: The ultrasound ciliary plasty (UCP) procedure affects corneal parameters, although the effect is transient. Ultrasound energy affects the sclera, leading to induced astigmatism. The area of energy application correlates with the astigmatism axis. Purpose: To assess the postoperative corneal topography for 1 year after UCP. Materials and Methods: In total, 78 patients with primary and secondary refractory glaucoma were enrolled in the study. The primary outcome measures were the corneal parameters obtained with anterior segment swept-source optical coherence tomography. Intraocular pressure, number of antiglaucoma medications, and best-corrected logMAR visual acuities were analyzed as secondary outcome measures. Measurements were performed preoperatively and at 1 week, and 1, 3, 6, and 12 months postoperatively. A total of 39 patients (39 eyes) completed the follow-up period of 12 months. Results: There was a significant difference in the anterior/posterior steep/flat keratometry and anterior/posterior astigmatism values immediately after UCP. However, 3 months postoperatively these parameters returned to their initial values and there were no significant differences noted. The mean +/- SD values of anterior astigmatism preoperatively and at 1 week, and 1, 3, 6, and 12 months postoperatively were 1.12 +/- 0.66 D, 2.17 +/- 0.91 D (P<0.001), 2.05 +/- 0.93 D (P<0.001), 1.55 +/- 0.75 D (P=0.004), 1.31 +/- 0.70 D (P=0.024), and 1.20 +/- 0.73 D (P=0.406), respectively. The astigmatism axis tended to approach 90 degrees meridian with a significant difference 1 week postoperatively. Central and minimal corneal thickness remained unchanged, whereas the intraocular pressure and the number of antiglaucoma medications decreased significantly. Conclusions: UCP influenced the corneal topography parameters in the immediate postoperative period; however, with time, all parameters returned to their initial values.