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Angle Closure Glaucoma: Treatment

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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...

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Updated: Oct 15, 2025

Ultrasound Cyclo Plasty in Eyes with Glaucoma

Ultrasound Cyclo Plasty in Eyes with Glaucoma

Published on: January 26, 2018

Does prior endoscopic cyclophotocoagulation (ECP) affect subsequent trabeculectomy outcomes?

Abhijit Anand Mohite¹, Emma Samia-Aly², Uthaya Shankar Ramanathan²

¹Wolverhampton and Midland Counties Eye Infirmary, New Cross Hospital, The Royal Wolverhampton Hospitals NHS Trust, Wolverhampton Road, Wolverhampton, WV10 0QP, UK. abhijit.mohite2@nhs.net.

Graefe'S Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie

|October 25, 2021

Summary

Endoscopic cyclophotocoagulation (ECP) is a safe initial glaucoma treatment that may reduce the need for trabeculectomy. Long-term outcomes show ECP does not compromise results for patients requiring subsequent trabeculectomy.

Keywords:

Endoscopic cyclophotocoagulation Glaucoma Minimally invasive glaucoma surgery Trabeculectomy

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Area of Science:

Ophthalmology
Glaucoma Surgery
Medical Optics

Background:

Glaucoma management often requires surgical intervention to lower intraocular pressure (IOP).
Trabeculectomy is a common glaucoma surgery, but carries risks and potential complications.
Endoscopic cyclophotocoagulation (ECP) is an alternative or adjunctive procedure for glaucoma treatment.

Purpose of the Study:

To evaluate the long-term efficacy and safety of trabeculectomy performed after prior endoscopic cyclophotocoagulation (ECP).
To compare the outcomes of trabeculectomy in eyes with prior ECP versus primary trabeculectomy.

Main Methods:

A retrospective, case-controlled comparative study design.
Two groups were analyzed: Group 1 (trabeculectomy after failed ECP) and Group 2 (primary trabeculectomy).
Two-year outcomes including IOP, medication use, and success rates were compared between groups.

Main Results:

No significant differences in mean 2-year IOP or medication use were observed between groups.
Complete success rates were 77.8% for ECP followed by trabeculectomy and 88.9% for primary trabeculectomy.
Qualified and combined success rates were comparable, with no significant differences in complications.

Conclusions:

ECP is a safe and effective initial procedure for progressive glaucomas.
ECP can significantly decrease the need for subsequent trabeculectomy.
Trabeculectomy outcomes are not compromised in the minority of patients requiring it after ECP.