Postoperative Inflammation After Endoscopic Cyclophotocoagulation: Racial Distribution and Effect on Outcomes

Area of Science:

• Ophthalmology
• Glaucoma Research
• Cataract Surgery

Background:

• Primary open-angle glaucoma (POAG) management often involves cataract surgery.
• Combined phacoemulsification and endoscopic cyclophotocoagulation (ECP) is a surgical option for POAG.
• Postoperative inflammation, such as anterior chamber reaction or persistent anterior uveitis (PAU), can occur.

Purpose of the Study:

• To determine the prevalence of PAU after combined phacoemulsification and ECP in POAG.
• To investigate the association between PAU and race.
• To evaluate the effect of PAU on intraocular pressure (IOP) and visual acuity (VA).

Main Methods:

• Retrospective analysis of 223 eyes undergoing combined phacoemulsification and ECP for POAG.
• Data collected included VA, IOP, anterior chamber inflammation, and medication use.
• Patients were categorized by self-reported race; PAU was treated based on severity.

Main Results:

• PAU occurred in 22.4% of eyes and was significantly correlated with African American race.
• PAU was associated with delayed inflammation improvement but not with poorer VA or IOP outcomes.
• No significant difference in IOP reduction at 3 months was observed between African Americans and whites regarding PAU.

Conclusions:

• PAU is a frequent complication after combined phacoemulsification and ECP in POAG, with a higher prevalence in African Americans.
• Despite requiring potentially prolonged treatment, PAU did not lead to worse visual acuity or intraocular pressure outcomes.
• Race is a significant factor in PAU development, but does not predict long-term IOP control post-surgery.