{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:56:03Z","timestamp":1777881363837,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Iantrek Inc"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ophthalmol Eye Dis"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Scleral allograft-reinforced cyclodialysis intervention can achieve sustained intraocular pressure (IOP) reduction by enhancing uveoscleral outflow in hypertensive patients with primary open-angle glaucoma (POAG) failing medical therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate clinical outcomes of bio-interventional uveoscleral outflow enhancement surgery through 12\u2009months of follow-up in POAG subjects who are inadequate responders to IOP-lowering medical treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Prospective interventional real-world evidence trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients with POAG and medicated baseline IOP &gt;21\u2009mmHg failing medical therapy underwent bio-interventional uveoscleral outflow enhancement surgery with an ab-interno allograft-reinforced cyclodialysis. Acellular allogeneic scleral bio-tissue was micro-trephined, shaped, and loaded in a delivery cannula for internal scaffolding. Endoscleral reinforcement of the cyclodialysis was then performed to maintain the internal uveoscleral filtration conduit. Effectiveness outcomes such as IOP and IOP-lowering medication use, as well as ocular safety and tolerability, were analyzed through 12\u2009months post-op.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Fifty-one eyes were enrolled with a baseline medicated IOP greater than 21\u2009mmHg. The average age was 70.9\u2009\u00b1\u20098.5. The mean best corrected visual acuity (BCVA) at baseline was 0.40\u2009\u00b1\u20090.32, and the mean medicated IOP was 25.7\u2009\u00b1\u20094.4\u2009mmHg on 1.2\u2009\u00b1\u20091.3 IOP-lowering medications. In 83% of cases, visually significant cataract comorbidity was present and treated with adjunct phacoemulsification. The bio-interventional cyclodialysis surgery and scleral reinforcement were successfully performed in all cases. The procedures were well tolerated, and there were no visually significant or serious, vision-threatening ocular adverse events. Durable and sustained reinforcement of the cyclodialysis was achieved through 12\u2009months of follow-up without migration, displacement, or attrition of the allograft bio-scaffold. At 12\u2009months post-op, there was a statistically significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and sustained reduction in IOP from 25.7\u2009+\u20094.4\u2009mmHg at baseline down to 15.4\u2009\u00b1\u20094.5\u2009mmHg, with a concurrent 42% reduction in IOP-lowering medications. 86.7% of subjects achieved a medicated IOP &lt;18\u2009mmHg while on fewer or the same number of IOP-lowering medications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Uveoscleral outflow enhancement can be surgically enhanced in an ab-interno approach through bio-interventional cyclodialysis with adjunct scleral allograft reinforcement to lower IOP in open-angle glaucoma patients who are inadequate responders to medical therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration:<\/jats:title>\n                    <jats:p>The study was registered with clinicaltrials.gov NCT05506423.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/25158414251362010","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T10:35:47Z","timestamp":1754908547000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Bio-interventional uveoscleral outflow enhancement in patients with medically uncontrolled primary open-angle glaucoma: 1-year results of allograft-reinforced cyclodialysis"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4784-920X","authenticated-orcid":false,"given":"Kevin","family":"Barber","sequence":"first","affiliation":[{"name":"Central Florida Eye Specialists, Deland, FL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Flowers","sequence":"additional","affiliation":[{"name":"Ophthalmology Associates, Forth Worth, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Patterson","sequence":"additional","affiliation":[{"name":"Eye Centers of Tennessee, Crossville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lautaro","family":"Vera","sequence":"additional","affiliation":[{"name":"Panama Eye Clinic, Panama, Panama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9893-5909","authenticated-orcid":false,"given":"Tsontcho","family":"Ianchulev","sequence":"additional","affiliation":[{"name":"New York Eye and Ear Infirmary of Mount Sinai, Icahn School of Medicine, 310 E 14th Street Suite, 319 South, New York City, NY 10003-4201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iqbal Ike","family":"Ahmed","sequence":"additional","affiliation":[{"name":"John Moran Eye Center, University of Utah, Salt Lake City, UT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/ceo.14028"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01289-8"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00061198-200010000-00001"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6257(02)00306-5"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/08820538.2021.1903513"},{"key":"e_1_3_4_7_2","unstructured":"Freeman W. 2023 glaucoma surgical device market report: global analysis for 2022 to 2028 July 2023: market scope glaucoma surgery market: market size growth forecasts and market share | Market scope https:\/\/www.market-scope.com\/pages\/reports\/393\/2023-glaucoma-surgical-device-market-report-global-analysis-for-2022-to-2028-july-2023 (2023 accessed 24 June 2024)."},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1949.00900050616010"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S80490"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2020.09.005"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2010.07.007"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2019.04.034"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/ceo.12805"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0014-4835(66)80019-2"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(99)00266-4"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/ceo.13989"},{"issue":"5","key":"e_1_3_4_17_2","first-page":"119","article-title":"Cyclodialysis for chronic glaucoma","volume":"5","author":"Sewall EC.","year":"1907","unstructured":"Sewall EC. 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