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Phacoemulsification plus endoscopic cyclophotocoagulation versus phacoemulsification alone in primary open-angle

Francisco Pérez Bartolomé1,2, Ian A Rodrigues2, Saurabh Goyal2

  • 11 Department of Ophthalmology, Hospital Clínico San Carlos, Madrid - Spain.

European Journal of Ophthalmology
|October 28, 2017
PubMed
Summary

Combined phacoemulsification and endoscopic cyclophotocoagulation (phaco-ECP) significantly lowers intraocular pressure (IOP) more effectively than phacoemulsification alone in primary open-angle glaucoma (POAG) patients. This approach also reduces medication needs, offering a superior treatment option.

Keywords:
Endoscopic cyclophotocoagulationPhacoemulsificationPrimary open-angle glaucoma

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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Surgical Innovation

Background:

  • Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
  • Effective intraocular pressure (IOP) management is crucial for preventing glaucomatous optic neuropathy.
  • Current treatments often involve multiple medications or invasive surgeries.

Purpose of the Study:

  • To compare the efficacy and safety of combined phacoemulsification and endoscopic cyclophotocoagulation (phaco-ECP) versus phacoemulsification alone for POAG.
  • To evaluate the impact on intraocular pressure (IOP), medication usage, and visual acuity.
  • To assess postoperative complications associated with phaco-ECP in POAG patients.

Main Methods:

  • Retrospective review of 99 primary open-angle glaucoma (POAG) patient records from two London eye departments.
  • Inclusion of 69 patients undergoing phaco-ECP and 30 age- and sex-matched controls undergoing cataract surgery alone.
  • Data collection over 12 months, focusing on intraocular pressure (IOP), visual acuity (VA), medication count, and complications.

Main Results:

  • Phaco-ECP demonstrated a significantly higher success rate (69.6%) compared to phacoemulsification alone (40%) after one year (p=0.004).
  • The phaco-ECP group experienced greater reductions in mean IOP (4.5 mmHg vs 1.83 mmHg) and medication number (0.73 vs 0.23).
  • Both groups showed similar visual acuity improvements, with a slightly higher incidence of minor, self-limiting complications in the phaco-ECP group.

Conclusions:

  • Combined phaco-ECP is more effective than phacoemulsification alone in reducing IOP and medication burden in POAG patients.
  • Phaco-ECP offers a promising surgical option for managing POAG, balancing efficacy with manageable complications.
  • Further research may explore long-term outcomes and patient-specific indications for phaco-ECP.