Efficacy and safety of single Ultrasound Cyclo-Plasty to treat refractory glaucoma: Results at 1 year.

PURPOSE: To evaluate clinical efficacy and safety of single Ultrasound Cyclo-Plasty (UCP) in the treatment of advanced refractory glaucoma. METHODS: From January 2018 to August 2018, 25 patients (25 eyes) with refractory glaucoma and intraocular pressure (IOP) not controlled by drugs or conventional filtering surgery were included in the study. All subjects (neovascular glaucoma [n = 12], secondary glaucoma [n = 6], angle closure glaucoma [n = 6], and primary open angle glaucoma [n = 1]) underwent 8-sector Ultrasound Cyclo-Plasty. Patients were followed-up at Day 1, Week 1, and at 1, 3, 6, and 12 months, during which the IOP, the number of IOP lowering drugs and the occurrence of ocular complications were recorded. Clinical outcomes were IOP reduction, success rate, and ocular complications. According to the glaucoma type, patients were divided into a neovascular group (NVG) and a non-NVG group for sub-analysis. RESULTS: All patients underwent a single UCP procedure and mean IOP reduced significantly from 39.7 ± 6.1 mmHg before UCP to 27.1 ± 11.0 mmHg at 1 year (p < 0.01) corresponding to a mean IOP reduction of 29.6%. The mean number of IOP-lowering drugs used was 2.4 ± 1.2 at baseline and 2.3 ± 1.0 at 12 months. Success rate after a single UCP procedure was achieved in 41.7% patients at 1 year, with a higher success rate in non-NVG than in the NVG group. No major postoperative complications were reported. The main complication was conjunctival congestion, anterior chamber inflammation, scleral ring congestion, and scleral inprint. Of these, scleral ring congestion and scleral imprint are relatively rare complications, which can still be observed 12 months after UCP treatment. CONCLUSION: UCP for refractory glaucoma is effective in reducing IOP and has a good safety profile. Success rate is lower after a single UCP in NVG than for other types of glaucoma.

Serum homocysteine levels of retinal vein occlusion patients with different ages and types / 中华眼底病杂志

Objective To observe serum homocysteine (Hcy) levels in retinal vein occlusion (RVO) patients with different ages and types.Methods A total of 79 patients (79 eyes) diagnosed with RVO were enrolled.There were 33 females and 46 males,the mean age was (57.00± 9.29) years.Eighty-two age-and sex-matched patients (82 eyes) without retinal vascular disease were included as controls.There were 32 females and 50 males,the mean age was (60.00± 10.15) years.Among RVO patients,there were 24 patients younger than 50 years old (young patients) and 55 patients older than 50 years old (elderly patients);35 patients with central RVO (CRVO) and 44 patients with branch RVO (BRVO).Fasting plasma Hcy,serum vitamin (Vit) B6,B12 and folate levels were measured in all patients.The relationship of high Hcy,low VitB6,low folate and RVO with different age were analyzed.Results Hcy level was significantly higher in RVO patients than control subjects (t =2.946,P ＜ 0.01).Blood concentration of folate and VitB6 were significantly lower in RVO patients than control subjects (t=2.641,2.889;P＜0.01).Blood level of VitB12 was significantly different in RVO patients from control subjects (t =1.665,P＞0.05).Concentrations of Hcy,folate,VitB12 and VitB6 were not different between patients with CRVO and BRVO (t =0.756,1.306,0.682,1.306;P＞ 0.05).Hcy level was significantly higher in the young RVO patients than in the elderly RVO patients (t=2.394,P＜0.05).Blood concentration of folate and VitB6 were lower in the young RVO patients than in the elderly RVO patients,but the difference were not significant(t=1.318,1.694;P＞0.05).The number of patients with high Hcy [x2=13.67,odds ratio (OR) =3.327,95％ confidence interval (CI) =1.742-6.354],low VitB6 (x2 =5.28,OR =2.068,95％CI=1.103-3.878) and low folate status (x2 =8.642,OR=2.546,95％CI=1.349-4.806) in RVO patients were more than control subjects (P=0.0001,0.023,0.004).Conclusions High Hcy,low folate and low VitB6 were risk factors for the onset of RVO.Hcy may play more important role in young patients with RVO.Hcy,folate and VitB6 levels were similar in CRVO and BRVO patients.