Scleral Allograft-Reinforced Cyclodialysis Combined with Phacoemulsification or Performed as a Standalone Procedure: 24-Month Outcomes from the Multicenter CREST Study

Acellular scleral allograft-reinforced cyclodialysis lowered intraocular pressure and medication burden through 24 months, with medication-free rates rising to 46.4% in phaco-combined eyes.

• Why it matters: Open-angle glaucoma needs durable intraocular pressure control with acceptable safety, but real-world 2-year outcomes comparing combined versus standalone use are limited.
• What they did: In the multicenter CREST real-world evidence study (NCT05506423), 176 phaco-combined eyes and 32 standalone eyes were analyzed at Month 24, censoring values after secondary procedures.
• The result: Phaco-combined eyes saw IOP drop 3.1 mmHg from 18.0 (p < 0.001) and medications drop 0.5 from 1.5 (p < 0.001), while standalone eyes saw IOP drop 6.4 mmHg from 20.0 (p < 0.001) and medications drop 1.2 from 2.8 (p = 0.004), with no clinically significant hypotony or choroidal effusion and no allograft-related vision-threatening adverse events.

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