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Abstract #51951 Published in IGR 14-4
Combining phacoemulsification with endoscopic cyclophotocoagulation to manage cataract and glaucoma
Clement CI; Kampougeris G; Ahmed F; Cordeiro MF; Bloom PAClinical and Experimental Ophthalmology 2013; 41: 546-551
See also comment(s) by Ronald Fellman •
BACKGROUND: to examine the outcome and complications of combined phacoemulsification and endoscopic cyclophotocoagulation (phaco-ECP) as surgical management of cataract and glaucoma. DESIGN: retrospective uncontrolled case series from the glaucoma unit, Western Eye Hospital, London, UK PARTICIPANTS: 63 eyes from 59 patients with co-existing cataract and glaucoma METHODS: patients underwent routine phaco-emulsification followed by 270 - 360 degree endoscopic cyclophotocoagulation as a single procedure. MAIN OUTCOME MEASURES: Intraocular pressure (IOP), number of IOP-lowering medications, Log MAR visual acuity, recorded complications. RESULTS: Baseline characteristics included mean age (77.3 ± 11.1 years), mean Log MAR visual acuity (1.01 ± 0.98), mean IOP (21.13 ± 6.21 mmHg) and mean number of IOP-lowering medications, (2.71 ± 1.06). Twelve months after phaco-ECP, mean IOP had reduced to 16.09 ± 5.27 mmHg (p < 0.01), number of IOP-lowering medications reduced to 1.47 ± 1.30 (p < 0.01) and mean Log MAR acuity improved to 0.33 ± 0.22 (p < 0.01). Success, defined as an IOP reduction > 20% with IOP 6 - 21mmHg, was achieved in 55.5% of eyes at 12 months. Complications included fibrinous uveitis, elevated IOP, posterior vitreous detachment and induced astigmatism. CONCLUSION: phaco-ECP is both safe and effective as surgical management for cataract and glaucoma. Larger IOP reductions can be achieved in older patients and those with higher baseline IOP.
Glaucoma Unit, Western Eye Hospital, London, UK; Ophthalmology Unit, The Hillingdon Hospital, London, UK; Glaucoma Unit, Sydney Hospital and Sydney Eye Hospital, Australia; Discipline of Ophthalmology, The University of Sydney, Australia.
Full articleClassification:
12.10 Cyclodestruction (Part of: 12 Surgical treatment)
12.12.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.12 Cataract extraction)
