Bio-interventional Uveoscleral Outflow Enhancement Surgery for Primary Open-Angle Glaucoma: 2-Year Results of Cyclodialysis with Scleral Allograft Reinforcement

Abstract

Objective

To evaluate safety and efficacy of the scleral allograft–reinforced cyclodialysis through 24 months of follow-up.

Design

Interventional single-center case series.

Participants

Thirty-one eyes with primary open-angle glaucoma and visually significant cataracts underwent bio-interventional cyclodialysis surgery with scleral allograft reinforcement combined with phacoemulsification.

Intervention

Uveoscleral outflow enhancement surgery comprised of cyclodialysis with sequential bio-reinforcement with a scleral allograft combined with phacoemulsification.

Main Outcome Measures

The primary outcome was the proportion of eyes achieving ≥20% intraocular pressure (IOP) reduction with same or fewer medications compared with baseline. Secondary outcomes included the mean change in medicated IOP and mean number of IOP-lowering medications compared with baseline. Adverse events were also recorded and evaluated throughout the study.

Results

The primary outcome was achieved in 74% of the eyes, and there was a mean IOP reduction of 34% compared with baseline. Baseline mean medicated IOP was 21.9 ± 4.92 mmHg on 1.22 ± 1.29 IOP-lowering medications. At 12 months postoperation, mean IOP was 12.62 ± 2.63 on 0.55 ± 0.52 glaucoma medications. The procedure was well tolerated, and there were no serious ocular adverse events.

Conclusions

Uveoscleral outflow enhancement can be successfully achieved at the time of cataract surgery through bio-interventional cyclodialysis and scleral allograft reinforcement to lower IOP in patients with primary open-angle glaucoma.

Financial Disclosure(s)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.