Autores
Ernesto Calvo, MD¹; Ticiana De Francesco, MD²˒³˒⁴; Lautaro Vera, MD¹; Farrell Tyson, MD, FACS⁵; Robert N. Weinreb, MD⁶.
Objetivo
To evaluate the safety and efficacy of scleral allograft-reinforced cyclodialysis through 24 months of follow-up.
Desenho do estudo
Interventional, single-center case series.
Participantes
Thirty-one eyes with primary open-angle glaucoma and visually significant cataracts underwent biointerventional cyclodialysis surgery with scleral allograft reinforcement combined with phacoemulsification.
Intervenção
Uveoscleral outflow enhancement surgery consisted of cyclodialysis with sequential bioreinforcement using a scleral allograft, combined with phacoemulsification.
Principais medidas de desfecho
The primary outcome was the proportion of eyes achieving a 20% reduction in intraocular pressure (IOP) while using the same number or fewer IOP-lowering medications compared with baseline.
Secondary outcomes included the mean change in medicated IOP and the mean number of IOP-lowering medications compared with baseline. Adverse events were also recorded and evaluated throughout the study.
Resultados
The primary outcome was achieved in 74% of the eyes, with a mean IOP reduction of 34% compared with baseline.
The baseline mean medicated IOP was 21.9 ± 4.92 mmHg, with patients using an average of 1.22 ± 1.29 IOP-lowering medications.
At 12 months after surgery, the mean IOP was 12.62 ± 2.63 mmHg, while the average number of glaucoma medications was reduced to 0.55 ± 0.52.
The procedure was well tolerated, and no serious ocular adverse events were reported throughout the study.
Conclusão
Uveoscleral outflow enhancement can be successfully achieved at the time of cataract surgery through biointerventional cyclodialysis combined with scleral allograft reinforcement.
The procedure resulted in a substantial reduction in intraocular pressure while reducing the need for glaucoma medications in patients with primary open-angle glaucoma. The favorable safety profile observed during follow-up supports the potential role of this technique as an alternative surgical approach for IOP reduction.
Declaração financeira
The authors have no proprietary or commercial interest in any materials discussed in this article.
Referência
Ophthalmology Science. 2025;5:100727. © 2025 by the American Academy of Ophthalmology.
This is an open-access article distributed under the CC BY license.