Efficacy and Safety of Repeated Ultrasound Cycloplasty Procedures in Patients With Early or Delayed Failure After a First Procedure

Precis: Repeated ultrasound cycloplasty (UCP) procedures are valuable options in patients with early or delayed intraocular pressure (IOP) increase after a first procedure. The safety of a second procedure is similar to that of the first one. Purpose: The purpose of this study was to evaluate the efficacy and safety of repeated UCPs in patients with early or delayed IOP increase after a first procedure. Patients and Methods: Thirty-one eyes with open-angle glaucoma, with an IOP decrease,>20% after a first UCP procedure (1 and/or 2 mo visit), and with an early or delayed IOP increase (IOP decrease<20% compared with baseline before or after the first 6 mo, respectively), underwent a second UCP procedure. Examinations were performed at 1 day, 1 week, 1, 2, 3, 6, and 12 months. Primary outcomes were surgical success (IOP reduction >= 20% and IOP>5 mm Hg) at the last follow-up and vision-threatening complications. Secondary outcomes were mean IOP at each visit, medication use, and other surgical interventions. Results: In the group with early IOP increase, IOP was reduced (P<0.05) from a mean value of 29.8 +/- 8.2 mm Hg before retreatment (n=3.3 medications) to 18.5 +/- 7.4 mm Hg at the last follow-up (n=3.5 medications) (-34%). Success was achieved in 52.6% of eyes (10/19) at the last follow-up visit. In the late IOP increase group, IOP was reduced (P<0.05) from a mean value of 31.9 +/- 6.6 mm Hg before retreatment (n=4.0 medications) to 16.2 +/- 5.2 mm Hg at the last follow-up (n=4.0 medications) (-43%). Success was achieved in 55.5% of eyes (5/9) at the last follow-up visit. No major intraoperative or postoperative complications occurred. Conclusion: A second UCP procedure could be considered in subjects with early or delayed failure after a first procedure.