Clinical Report: Restoring Access to Uveoscleral Outflow
Overview
The CREST trial data presented at the 2025 American Glaucoma Society meeting indicates a significant reduction in intraocular pressure (IOP) and the number of medications required in patients with primary open-angle glaucoma (POAG) undergoing bioreinforced cyclodialysis. This innovative procedure enhances uveoscleral outflow, demonstrating both safety and effectiveness over a two-year period.
Background
Elevated intraocular pressure (IOP) is a primary risk factor for glaucoma progression, necessitating effective management strategies. Traditional surgical options, while effective, can be invasive and carry significant risks. The bioreinforced cyclodialysis procedure offers a novel approach to enhance uveoscleral outflow, potentially providing a less invasive alternative for patients requiring additional IOP control.
Data Highlights
| Measure | Baseline | 24 Months |
|---|---|---|
| Mean IOP (mmHg) | 19.5 ± 4.9 | 14.6 ± 6.7 |
| Medicated IOP-lowering medications | 1.61 ± 1.4 | 0.70 ± 0.81 |
Key Findings
- The bioreinforced cyclodialysis procedure significantly reduced mean IOP by approximately 25% over 24 months.
- Mean medicated IOP-lowering medications decreased from 1.61 to 0.70.
- The safety profile of the procedure was deemed acceptable by the presenting physician.
- Uveoscleral drainage may account for 25-40% of aqueous outflow, highlighting its importance in IOP management.
- The CycloPen system facilitates the creation of a cyclodialysis cleft, enhancing surgical outcomes.
Clinical Implications
Specify that the findings are particularly relevant for patients undergoing cataract surgery.
Conclusion
Bioreinforced cyclodialysis represents a promising advancement in glaucoma surgery, offering significant IOP reduction and medication savings while maintaining a favorable safety profile.
References
- Herndon, L.W., Glaucoma Physician, 2025 -- Restoring Access to Uveoscleral Outflow
- Pan, B., Desai, P., Glaucoma Physician, 2025 -- Unlocking Uveoscleral Outflow: A New Path Awaits Post-MIGS
- Turer, T.I., Sheybani, A., Glaucoma Physician, 2025 -- Unlocking the Supraciliary Space
- Glaucoma Physician — Unlocking the Supraciliary Space
- Glaucoma Physician — Unlocking Uveoscleral Outflow: A New Path Awaits Post-MIGS
- Primary Open-Angle Glaucoma Preferred Practice Pattern® - PubMed
- Alcon announces voluntary global market withdrawal of CyPass Micro-Stent for surgical glaucoma
- Restoring Access to Uveoscleral Outflow | Glaucoma Physician
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