Phaco-endocyclophotocoagulation versus phaco-trabeculectomy in advanced glaucoma: A pilot study.

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Minimally Invasive Glaucoma Surgery (MIGS)

Background:

• Advanced primary glaucomas require effective surgical management.
• Phaco-trabeculectomy (PT) is the current gold standard treatment.
• Minimally invasive glaucoma surgery (MIGS) offers potential advantages.

Purpose of the Study:

• To compare the safety and efficacy of phaco-endocyclophotocoagulation (ECP) with phaco-trabeculectomy (PT) in advanced primary glaucomas.
• To evaluate intraocular pressure (IOP) reduction, medication use, visual acuity, and complications.

Main Methods:

• Retrospective study comparing phaco-ECP (28 eyes) and PT (24 eyes) in patients over 30 years old with advanced primary glaucomas.
• Primary outcome: IOP. Secondary outcomes: anti-glaucoma medications (AGMs), best-corrected visual acuity (BCVA), success rates, complications, and interventions.
• Mean follow-up: 18 months for phaco-ECP, 16 months for PT.

Main Results:

• Both phaco-ECP and PT significantly reduced IOP (p=.667) and AGMs (p=.624).
• Phaco-ECP demonstrated a significant improvement in BCVA (p=.04) with fewer complications and interventions compared to PT (p=.05).
• No sight-threatening complications or vision loss occurred in either group; PT had two failures.

Conclusions:

• Phaco-ECP is a potentially effective and safer alternative to PT for advanced primary glaucomas.
• Phaco-ECP offers improved BCVA and reduced need for interventions.
• Larger studies with longer follow-up are recommended to confirm these findings.