Cataract and glaucoma surgery: Endoscopic cyclophotocoagulation versus trabeculectomy

Marco, Sheila Akinyi; Damji, Karim F.; Nazarali, Samir; Rudnisky, Christopher J.

doi:10.4103/meajo.meajo_232_16

Cited by 7 publications

(7 citation statements)

References 12 publications

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“…Ten of the included studies[ 30 31 33 34 35 36 37 38 39 ] reported the success rate of ECP and non-ECP in treating refractory glaucoma. These values were reported based on the longest follow-up period.…”

Section: Resultsmentioning

confidence: 99%

Endoscopic cyclophotocoagulation for glaucoma compared to alternative procedures –A Systematic review

Alasbali

2023

Oman Journal of Ophthalmology

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INTRODUCTION: Despite many recent developments, preference in the choice of surgical treatment of uncontrolled intraocular pressure (IOP) remains a challenge. OBJECTIVE: This study compares the clinical efficacy and safety of endoscopic cyclophotocoagulation (ECP) to alternative surgical procedures, for all types of glaucoma. METHODOLOGY: The methodology adheres to the preferred reporting items for systematic reviews and meta-analyses guidelines for systematic review reporting. Studies reporting ECP and alternative surgeries in treating refractory glaucoma, neovascular glaucoma, aphakic glaucoma, filtering surgical failure-induced glaucoma, congenital or juvenile glaucoma, and secondary glaucoma such as uveitis glaucoma, traumatic glaucoma, secondary glaucoma postcorneal transplantation, etc. were included. The efficacy was evaluated from the number of IOP-lowering drugs, and mean change in pre- and post-IOP were the outcomes assessed in ECP and non-ECP groups in this review. Evaluations of the postoperative complications revealed the safety assessment of the procedure. RESULTS: In total, 11 relevant studies were selected in this study with a total of 5418 eyes, including 763 eyes in the ECP group and 4655 in the non-ECP group. This review observed that both ECP and non-ECP procedures had been successful in reducing postoperative IOP. CONCLUSION: It can be deduced from this review, that all types of glaucoma can be treated efficiently with significantly higher success rates with ECP and ECP demonstrates lowest postoperative complications when compared to non ECP procedures. This review provides updated scientific evidence which caters to support clinical decisions for surgical treatment of glaucoma.

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Section: Resultsmentioning

confidence: 99%

Endoscopic cyclophotocoagulation for glaucoma compared to alternative procedures –A Systematic review

Alasbali

2023

Oman Journal of Ophthalmology

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“…Another prospective study published earlier also concluded that phaco-ECP was an effective alternative to phaco-trabeculectomy in reducing IOP and medication requirement, and was reasonably safe with a similar rate of additional surgical intervention (43). Compared to trabeculectomy alone, ECP is generally associated with less serious complications except in refractory glaucoma (44), and the most common complications are IOP spikes (14.5%) and hemorrhages (3.8%) according to the ECP Collaborative Study (45). Performing ECP with phacoemulsification has not been shown to increase the risk of serious complications compared to phacoemulsification alone (42).…”

Section: Endoscopic Cyclophotocoagulation (Ecp)mentioning

confidence: 98%

The role of lens extraction in glaucoma management

2020

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Cataract extraction has become a much safer procedure with the development of phacoemulsification, extending its application in ocular conditions such as glaucoma for better disease control.This review aims at summarizing the effect of lens extraction with or without combined glaucoma surgeries in different types of glaucoma and describing the intraoperative techniques and changes of glaucoma care postoperatively. A comprehensive literature search was performed through Medline and PubMed, and 67 studies were selected for this review. In primary angle closure (PAC) diseases, studies have revealed significant intraocular pressure (IOP) and medication requirement reduction after lens extraction. Fewer studies described its application in primary open angle glaucoma (POAG) and ocular hypertension (OHT), but literature available suggests that it can also lead to better disease control. Likewise, lower postoperative IOP and pressure fluctuations have been shown in normal tension glaucoma (NTG). Advanced glaucoma, shallow anterior chamber and pseudoexfoliation glaucoma (PXG) are three difficult scenarios that are commonly encountered in cataract operations. Special techniques in preventing complications such as wipe out phenomenon are depicted. Goniosynechialysis, endoscopic cyclophotocoagulation and trabecular microbypass stents are a few of the popular choices of glaucoma procedures that can be performed concomitantly with phacoemulsification but evidence of their efficacy needs to be further verified. Cataract operation can improve visual field and retinal nerve fiber layer examination parameters and it is advised to set new baselines after the surgery for subsequent progression monitoring. Clearance of an optically significant cataract results in better quality of life, and with detailed and thorough explanation of the indications, expectations and risks of the surgery, cataract extraction could be considered even in cases of advanced glaucoma.

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“…5 Trabeculectomy, the standard therapy for glaucoma, has a beneficial effect of lowering intraocular pressure. 6,7 However, clinical practice has revealed that in the course of treatment, patients' filters are susceptible to tissue edema, 8 fibroplasia and wound repair, which may result in blockage of filters, interruption of drainage, and ultimately operation failure. Moreover, the incidence of operationrelated complications may be high, resulting in poor therapeutic outcomes.…”

Section: Original Articlementioning

confidence: 99%

Microsurgical scleral drainage and trabeculectomy-scleral flap adjustable suture combination technique in the treatment of primary glaucoma

et al. 2019

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Objective: To investigate the clinical effect of microsurgical scleral drainage and trabeculectomy combined with scleral flap adjustable suture technique in the treatment of primary glaucoma. Methods: One hundred primary glaucoma patients (120 eyes) in Xinyu People’s Hospital of Jiangxi province were selected from July 2014 to June 2016. The patients were randomly divided into control group and study group. The control group was treated with compound trabeculectomy, while the study group was treated with microsurgical scleral drainage and trabeculectomy combined with scleral flap adjustable suture technique. In both groups of patients, intraocular pressure, functional filtering bleb formation, and complications before and after surgery were monitored for three days, one week, one month, three months, six months and one year, while anterior chamber depth was determined one week after operation. The extent of success of operation was compared between the two groups. Results: At three days, one week, one month, three months, six months and one year after surgery, intraocular pressure of study group was significantly lower than that of the control group (P<0.05). There was 93.33% formation of functional filtering blebs in the study group, which was significantly higher than that in the control group (60.00%, P<0.001). Moreover, normal anterior chamber formation was significantly higher in the study group (91.67%) than in the control group (71.67%, P<0.01). There was 95.00% operation success in the study group, relative to 68.33% success in the control group (P<0.001). Conclusion: Microsurgical scleral drainage and trabeculectomy combined with scleral flap adjustable suture technique has better curative effect on primary glaucoma than compound trabeculectomy. Moreover, it does not exacerbate complications. Therefore, the combination treatment technique merits clinical application. doi: https://doi.org/10.12669/pjms.36.2.1439 How to cite this:Xiahou L, Liu C, Zhou W, Yang S. Microsurgical scleral drainage and trabeculectomy-scleral flap adjustable suture combination technique in the treatment of primary glaucoma. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.1439 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Cataract and glaucoma surgery: Endoscopic cyclophotocoagulation versus trabeculectomy

Cited by 7 publications

References 12 publications

Endoscopic cyclophotocoagulation for glaucoma compared to alternative procedures –A Systematic review

Endoscopic cyclophotocoagulation for glaucoma compared to alternative procedures –A Systematic review

The role of lens extraction in glaucoma management

Microsurgical scleral drainage and trabeculectomy-scleral flap adjustable suture combination technique in the treatment of primary glaucoma

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