Postoperative complicated peripheral cortical cataract after ultrasound cycloplasty: a case report

BACKGROUND: Ultrasound cycloplasty (UCP) is a non-invasive procedure for glaucoma treatment. Using high-intensity focused ultrasound to work on the ciliary body, the generation of aqueous humor can be reduced and the drainage of aqueous humor through the uveoscleral pathway can be enhanced. Recently, this therapy is gradually gaining clinical recognition. We report a case of a patient with glaucoma who accepted UCP in another hospital, but because of a worsening of a preexistent cataract and an insufficient IOP lowering effect, finally underwent cataract surgery in both eyes in our hospital, during the surgery we observed the unusual opacities probably due to UCP mistreatment. CASE PRESENTATION: Patient was diagnosed as chronic angle closure glaucoma and catacract, accepted UCP on both eyes in another hospital 4 months ago. After the UCP therapy, the pupil was vertical ellipse, the UCP didn’t have a sufficient effect on IOP and forced us to do cataract surgery to lower IOP. During the cataract surgery, some unusual white opacities in the peripheral cortex with clear boundary were found. Inaccurate WtW measurement was the most likely cause of the injury, which resulted in the use of the small-size UCP probe and the downward movement of the UCP probe. CONCLUSION: UCP should not be a first line treatment in a patient with cataract and angle closure glaucoma, cataract extraction is a better choice. The appropriate case selection needs to be more strict and the preoperative indexes measurements need to be more accurate.