Ultrasound Cyclo Plasty After Failed Glaucoma Surgery: Outcomes and Complications

Introduction The purpose of this study is to report the outcomes and complications of ultrasound cyclo plasty (UCP) after failed glaucoma surgery. Methods A retrospective case series included patients with previously failed glaucoma surgery who underwent UCP at King Abdul Aziz University Hospital, Riyadh, Saudi Arabia, between 2016 and 2021. The main outcome measures were: intraocular pressure (IOP), number of antiglaucoma medications and presence of vision-threatening complications. The surgical outcome of each eye was based on the main outcome measures. Results Seventy eyes of 70 patients were included in the study. The mean follow-up period was 31.89 months (+/- 17.5). The IOP and the number of antiglaucoma medications decreased significantly from a mean of 23.91 mmHg (+/- 6.3) and 3.43 (+/- 0.8) to 17.88 mmHg (+/- 8.1) and 2.48 (+/- 1.3) and of 16.74 (+/- 7.9) and 2.11 (+/- 1.3) at the 12th and 24th months postoperatively, respectively (p < 0.01 for both). The success rates were 77.1% (54/70) and 48.6% (34/70), while the failure rates were 22.9% (16/70) and 2.9% (2/70) at the 12th and 24th months postoperatively, respectively. The cumulative probabilities of success were 70.0% (+/- 5.5%) and 47.1% (+/- 6.0%) at the 12th and 24th months postoperatively, respectively. The most common complications were anterior chamber reaction (24.3%), cataract development/progression (18.6%), hypotony/choroidal detachment (4.3%), phthisis bulbi (1.4%) and aqueous misdirection (1.4%). Conclusions UCP is an effective treatment modality to control IOP and decrease the burden of antiglaucoma medications in eyes with previously failed glaucoma surgery. Monitoring and counseling of possible postoperative complications are needed.