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Abstract #46485 Published in IGR 13-3
Phacoemulsification and endoscopic cyclophotocoagulation as primary surgical procedure in coexisting cataract and glaucoma
Lima FEL; de Carvalho DM; de Avila MPArquivos Brasileiros de Oftalmologia 2010; 73: 419-422
Purpose: To evaluate the safety and efficacy of phacoemulsification and endoscopic cyclophotocoagulation (ECP) as a primary surgical treatment for glaucoma and cataract. Methods: Three hundred and sixty-eight eyes from 243 patients with primary open-angle glaucoma and cataract from the Centro Brasileiro de Cirurgia de Olhos that underwent an uncomplicated surgery from October, 1998 to December, 2006 with at least 2 years of follow-up were retrospectively enrolled. The patients were excluded if presented a previous ocular history of any intraocular surgery or glaucoma laser treatment. Qualified success was defined as 5 mmHg < intraocular pressure (IOP) < 21 mmHg with or without topical antiglaucomatous drugs, and complete success as the same IOP levels without therapy at all timepoints. Additionally, the requirement of any further glaucoma surgery was defined as failure. Results: The mean follow-up was 35.15 (plus or minus) 8.14 months. The preoperative IOP (23.07 (plus or minus) 5.52 mmHg) was significantly greater than in the first postoperative day (13.14 (plus or minus) 6.09 mmHg), and months 1 (11.03 (plus or minus) 2.59 mmHg), 6 (12.33 (plus or minus) 3.01 mmHg), 12 (12.19 (plus or minus) 2.19 mmHg), 24 (12.14 (plus or minus) 2.89 mmHg) and in the last appointment (12.29 (plus or minus) 2.44 mmHg) (p<0.001 in all timepoints). The number of preoperative medications (1.44 (plus or minus) 0.97) decreased (0.37 (plus or minus) 0.74) (p<0.001). Furthermore, there was a significant improvement in the logMAR visual acuity (p=0.01). Three hundred and thirty-four eyes (90.76%) achieved qualified success, and 205 (55.7%) complete success. Complications included immediate postoperative IOP spike 14.4% (53/368), postoperative fibrin exudates in anterior chamber 7.06% (26/368), cystoid macular edema 4.34% (16/368), transitory hypotony 2.17% (8/368), iris bombe 1.08% (4/368). Conclusion: Phacoemulsification associated with endoscopic cyclophotocoagulation is safe and effective as a primary procedure for combined glaucoma and cataract. LA: Portuguese
F.E.L. Lima. Avenida T-2, 401, Bairro Bueno - Goiania (GO) - CEP 74210-010, Brazil.
Classification:
12.10 Cyclodestruction (Part of: 12 Surgical treatment)
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
