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Eur J Ophthalmol. 2015 Nov-Dec;25(6):483-9. doi: 10.5301/ejo.5000620. Epub 2015 May 13.

High-intensity focused ultrasound treatment in refractory glaucoma patients: results at 1 year of prospective clinical study.

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The Sam Rothberg Glaucoma Center, Goldschleger Eye Institute, Sheba Medical Center, Tel Aviv University, Tel Hashomer - Israel.



To evaluate the safety and efficacy of the ultrasonic circular cyclo-coagulation procedure using high-intensity focused ultrasound by a miniaturized annular device containing 6 piezoceramic transducers in patients with refractory glaucoma.


This was a prospective interventional noncomparative study of 20 eyes of 20 patients with refractory glaucoma. All eyes were treated with 6 activated transducers operating at 21 MHz. Ultrasound biomicroscopy and a complete ophthalmic examination were performed before the procedure and at 1 day, 1 week, and 1, 3, 6, and 12 months after the procedure. Primary outcomes were surgical success (defined as intraocular pressure (IOP) reduction from baseline ≥20% and IOP >5 mm Hg) at the last follow-up visit. Secondary outcomes were mean IOP at each follow-up visit compared to baseline, medication use, complications, and re-interventions.


Intraocular pressure was significantly reduced (p<0.01) from a mean preoperative value of 36.4 ± 5.7 mm Hg to a mean postoperative value of 22.5 ± 10.3 mm Hg at 12 months. Four patients needed to be re-treated. The mean IOP reduction achieved was 38%. Surgical success was achieved in 13 of 20 eyes (65%). No major intraoperative or postoperative complications occurred.


Ultrasonic circular cyclo-coagulation using high-intensity focused ultrasound delivered by a circular miniaturized device containing 6 piezoceramic transducers is an effective and well-tolerated method to reduce IOP in patients with refractory glaucoma.

[Indexed for MEDLINE]

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