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Abstract #60473 Published in IGR 16-4
Combined endoscopic cyclophotocoagulation and phacoemulsification versus phacoemulsification alone in the treatment of mild to moderate glaucoma
Boling WS; Faridi OS; Gupta CK; Kim C; Boling RC; Citron ME; Siegel MJ; Siegel LIClinical and Experimental Ophthalmology 2015; 43: 531-539
BACKGROUND: To evaluate the long-term effects of combined endoscopic cyclophotocoagulation (ECP) and phacoemulsification (phaco) vs. phacoemulsification alone on intraocular pressure (IOP) control and medication reliance in the treatment of mild to moderate glaucoma. DESIGN: Retrospective chart review in private practice setting by glaucoma fellowship trained surgeons. PARTICIPANTS: 261 eyes in the combined phaco-ECP group with 52 eyes in the phaco alone group. METHODS: Comparison of phaco-ECP to phaco alone over 36 months. MAIN OUTCOME MEASURES: Full and qualified success cumulative survival, IOP and medication reliance six to 36 months compared to baseline. Full success was defined as minimum 20% IOP reduction with a decrease of at least one ocular hypertensive medication. Qualified success was defined as IOP no higher than baseline with a decrease of at least one ocular hypertensive medication. RESULTS: At 36 months, mean IOP in the combined phaco-ECP group was 14.6 mmHg while the phaco alone group was 15.5 mmHg (P = 0.34). Mean medication reliance in the combined phaco-ECP group was 0.2 medications while the phaco alone group was 1.2 (P <0.001). Full success in the phaco-ECP group was 61.4%; the phaco alone group was 23.3% (P<0.001). Qualified success survival was 72.6% in the phaco-ECP group and 23.3% in the phaco alone group (P <0.001). CONCLUSIONS: Combined phaco-ECP effectively lowers or maintains IOP and results in ocular hypertensive medication reduction up to 36 months when compared to phaco alone. Therefore phaco-ECP may help to increase medication compliance and reduce glauocma progression in mild to moderate glaucoma.
Glaucoma Center of Michigan, Southfield, MI, USA; Kresge Eye Institute, Wayne State University, Detroit, MI, USA; Department of Ophtalmology, William Beaumont Hospital, Royal Oak, MI, USA.
Full articleClassification:
12.10 Cyclodestruction (Part of: 12 Surgical treatment)
12.12.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.12 Cataract extraction)
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
