Endoscopic cyclophotocoagulation combined with phacoemulsification versus phacoemulsification alone in medically...

Area of Science:

• Ophthalmology
• Glaucoma Management
• Cataract Surgery

Background:

• Open-angle glaucoma (OAG) often coexists with visually significant cataracts.
• Managing intraocular pressure (IOP) is crucial in OAG patients.
• Cataract surgery alone may not sufficiently control IOP in these patients.

Purpose of the Study:

• To compare the efficacy of combined endoscopic cyclophotocoagulation (ECP) and phacoemulsification cataract extraction versus cataract extraction alone.
• To evaluate outcomes in patients with medically controlled open-angle glaucoma (OAG) and visually significant cataract.

Main Methods:

• Prospective nonrandomized matched-control study involving glaucoma specialists and comprehensive ophthalmologists.
• Patients with medically controlled OAG and cataracts were divided into two groups: combined ECP and cataract extraction (study) or cataract extraction alone (control).
• Groups were matched for age and baseline IOP; outcomes measured included IOP change, medication use, visual acuity, and complications.

Main Results:

• The combined ECP and cataract extraction group showed a significant decrease in mean IOP (18.1 to 16.0 mm Hg) and glaucoma medications (1.5 to 0.4) over two years.
• The cataract extraction alone group had minimal changes in IOP (18.1 to 17.3 mm Hg) and medication use (2.4 to 2.0).
• Both groups had similar visual acuity outcomes and complication rates.

Conclusions:

• Combined ECP and cataract extraction is more effective than cataract extraction alone in reducing IOP and medication burden in OAG patients.
• This combined approach offers a viable option for managing coexisting OAG and cataracts.