Combined Phacoemulsification-Endoscopic Cyclophotocoagulation versus Phacoemulsification Alone in Primary...

Area of Science:

• Ophthalmology
• Glaucoma Research
• Surgical Innovation

Background:

• Primary angle-closure glaucoma (PACG) with coexisting cataract presents unique management challenges.
• Phacoemulsification is a standard cataract surgery, but its effect on IOP in PACG is limited.
• Endoscopic cyclophotocoagulation (ECP) is an adjunctive procedure to reduce aqueous humor production.

Purpose of the Study:

• To compare the efficacy of combined phacoemulsification plus ECP versus phacoemulsification alone in managing PACG with cataract.
• To assess the impact on intraocular pressure (IOP) and glaucoma medication requirements.

Main Methods:

• A prospective randomized controlled pilot study involving 48 PACG eyes with cataracts.
• Patients were randomized to receive either phacoemulsification plus ECP or phacoemulsification alone.
• Follow-up occurred every 3 months for 2 years, monitoring IOP and drug usage.

Main Results:

• Combined phacoemulsification plus ECP demonstrated a trend towards lower postoperative IOP and reduced glaucoma drug requirements compared to phacoemulsification alone.
• Statistical significance in IOP reduction was observed at 1, 12, and 24 months postoperatively.
• No significant differences were found in visual outcomes, complications, or need for further surgery between the groups.

Conclusions:

• Combined phacoemulsification plus ECP is noninferior to phacoemulsification alone for IOP control in PACG eyes with cataracts.
• While trends suggest benefits, further large-scale trials are needed to confirm the statistical significance of IOP and medication reduction.
• This pilot study supports the ongoing large-scale randomized controlled trial evaluating this combined approach.