Cyclodialysis Procedure with Scleral Reinforcement Effectively Lowers IOP in Open-Angle Glaucoma

A recent study published in Clinical Ophthalmology demonstrated that a bio-interventional cyclodialysis procedure with allograft scleral reinforcement significantly lowered intraocular pressure (IOP) in patients with open-angle glaucoma by enhancing uveoscleral outflow. The procedure utilized the CycloPen microinterventional system and AlloFlo, both developed by Iantrek.

The study, led by Robert N. Weinreb, MD, focused on the safety and efficacy of this innovative approach in glaucoma patients undergoing cataract surgery.

Methodology

The analysis included data from 117 eyes enrolled in the CREST Real-World Evidence interventional study, with a follow-up period of one year. Key metrics evaluated included IOP levels and the number of IOP-lowering medications used.

Baseline Characteristics

       • Mean Medicated IOP: 20.2 ± 6.0 mm Hg

       • Mean Number of Medications: 1.4 ± 1.3

Key Results

IOP Reduction and Medication Use

At 12 months post-surgery:

       • Mean IOP: Reduced to 13.9 ± 3.9 mm Hg.

       • Medication Use: Reduced to 0.8 ± 0.9 medications.

       • Success Rate: 81.9% of patients achieved a medicated IOP of ≤18 mm Hg while maintaining or reducing their medication usage.

Safety Profile

The procedure exhibited a favorable safety profile with a low rate of complications:

       • Postoperative Complications: Minimal, with no vision-threatening adverse events reported.

       • Secondary Glaucoma Surgeries: Required in only 3.2% of patients.

Conclusion

The combination of cyclodialysis with scleral reinforcement using CycloPen and AlloFlo offers a promising approach for IOP management in patients with open-angle glaucoma. The procedure not only achieved significant IOP reductions but also reduced dependence on medications, all while maintaining a strong safety profile.

This bio-interventional strategy could become a valuable addition to the treatment options available for glaucoma patients, particularly those undergoing cataract surgery. Further studies may help solidify its role in clinical practice.

Resource:

https://www.tandfonline.com/doi/full/10.2147/OPTH.S496631#d1e300