Phacoemulsification and endocyclophotocoagulation in uncontrolled glaucoma: Three-year results

Smith, Michael; Byles, Daniel; Lim, Lei-Ai

doi:10.1016/j.jcrs.2018.06.025

Cited by 18 publications

(21 citation statements)

References 9 publications

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“…However, due to limited length of follow-up and only 4 of 29 patients completed a 12-month follow-up, it would be difficult to make that conclusion without a larger sample size. ECP results have been variable, with some studies showing continued IOP lowering success for up to 2-3 years [6, 10, 25]. Perhaps our lower success rate over time could be attributed to our population which has a higher proportion of advanced and refractory glaucoma, and to our smaller ECP treatment zone.…”

Section: Discussionmentioning

confidence: 90%

“…Francis et al [15] showed that ECP combined with phacoemulsification was more effective than cataract extraction alone to lower IOP and decrease IOP lowering medication dependence specifically in eyes with mild to moderate glaucoma previously controlled with IOP lowering medications. However, a recent study by Smith et al indicated that these results are temporary [10]. Lima et al [6] in a prospective study comparing ECP to AGV in patients with refractory glaucoma who were pseudophakic and had undergone trabeculectomy with antimetabolite previously, demonstrated that IOP lowering was similar between the two groups and the ECP group had less complications comparted to the AGV group.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Smith et al studied the effects of combined phacoemulsification and 360 degree ECP over 3 years in 84 patients with uncontrolled glaucoma and no prior history of glaucoma surgery. They found that 58.3% of cases had met failure criteria at the end of 3 years [10]. Despite the literature on ECP, there has only been one study comparing ECP outcomes in patients of African descent [11].…”

Section: Introductionmentioning

confidence: 99%

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Results of Combined Endocyclophotocoagulation and Phacoemulsification in Patients of African Descent: A Retrospective Study

Waldman¹,

Desai²,

Rahman³

et al. 2019

Preprint

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Background: To evaluate the outcomes of combined endocyclophotocoagulation (ECP) and phacoemusification in regards to vision, refraction, intraocular pressure, medication dependence, and complications in patients of African descent at a tertiary care glaucoma practice. Methods: A retrospective chart review including all cases of ECP combined with phacoemulsification cataract surgery from October 2015 to March 2017 was performed. Exclusion criteria consisted of patients who were not of African descent and patients with < 1 month follow up. The primary outcome measured was IOP at the latest follow-up. Results: 32 eyes of 29 patients were included in the study. Average IOP decreased from 17.30 ±6.30 mmHg preoperatively to 15.88 ±4.23 mmHg at the last post-operative visit (p = 0.301). 2/8 patients who did not demonstrate a difference in pre- and post-operative IOP changes were able to be weaned off all of their IOP lowering medications. The average follow-up was 5.05 ± 4.08 months with a range of 1 to 18 months. The average number of medications used per patient for IOP control decreased from 2.59 ±1.01 preoperatively to 1.97 ±1.38 (p = 0.045). Average visual acuity improved from 20/50 preoperatively to an average of 20/25 (p = 0.002). The post-operative complication rate was low. Conclusions: ECP combined with phacoemulsification can be effective at decreasing IOP lowering medication dependence in patients of African descent while also demonstrating variable IOP outcomes. While some patients with primary open angle glaucoma (POAG) and prior glaucoma surgery may experience a robust response to this treatment, others may not. We found that combined ECP and phacoemulsification can lead to a significantly decreased dependence on IOP lowering drops, with some patients demonstrating complete independence from drops following surgery. Although there was not a significant decrease in IOP post-operatively when analyzed collectively, larger studies may be able to find such an association. Combined ECP and phacoemulsification has been shown to be a safe combination in patients with refractive glaucoma and may be considered if a patient desires less dependence on IOP lowering drops once other first-line methods have failed, or as a bridge between conservative and more definitive surgical treatment. Keywords: Endocyclophotocoagulation, phacoemusification, African decent

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Results of Combined Endocyclophotocoagulation and Phacoemulsification in Patients of African Descent: A Retrospective Study

Waldman¹,

Desai²,

Rahman³

et al. 2019

Preprint

View full text Add to dashboard Cite

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“…Smith et al 19 reported that IOP decreased from 18.7 mmHg preoperatively to 13.3 mmHg and 14.0 mmHg at 1 and 3 years postoperatively in a patient treated with phacoemulsification and ECP, respectively. Siegel et al 20 also reported an approximately 20% reduction in IOP at the 36month follow-up in patients treated with combined phacoemulsification and ECP.…”

Section: Discussionmentioning

confidence: 99%

Combined Phacoemulsification and 360-Degree Endocyclophotocoagulation with and without a Kahook Dual Blade in Patients with Primary Open-Angle Glaucoma

Izquierdo¹,

Agudelo²,

Rubio³

et al. 2021

OPTH

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“…Detailed pre-and postoperative gonioscopic examinations identify the presence and extent of PAS and predict long-term IOP changes. Phaco/IOL combined with goniosynechialysis or endocyclophotocoagulation (ECP) may be considered in eyes with extensive PAS to achieve better IOP control [24][25][26].…”

Section: Kaplan-meier Survival Estimatesmentioning

confidence: 99%

Early versus Delayed Phacoemulsification and Intraocular Lens Implantation for Acute Primary Angle-Closure

Lin

Huang

et al. 2020

Journal of Ophthalmology

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Purpose. To compare the effects of early phacoemulsification and intraocular lens implantation (phaco/IOL), delayed phaco/IOL after initial laser peripheral iridotomy (LPI), and conventional LPI alone in patients with acute primary angle-closure (PAC). Methods. Patients with acute PAC were included in the study, and those with secondary glaucoma, prior ocular trauma, or other ocular diseases and those who had undergone ocular surgeries previously were excluded. Patients were categorized into three groups: Group A, which underwent primary phaco/IOL after acute PAC; Group B, which underwent LPI initially after acute PAC, followed by phaco/IOL within 6 months; and Group C, which underwent LPI alone. The IOP control success at 12 months as well as changes in ocular characteristics and the number of antiglaucoma medications used after the treatment among the groups were evaluated. Results. Eighty-one eyes were included in the study: 24 eyes in Group A, 23 eyes in Group B, and 34 eyes in Group C. The linear mixed model analysis demonstrated considerable IOP control in Groups A and B. Visual acuity, anterior chamber depth (ACD), and angle width improved significantly in Groups A and B, but not in Group C. The number of antiglaucoma medications used was significantly higher in Group C than in Groups A and B. Conclusions. Patients who underwent phaco/IOL had better IOP control, improved vision, deeper ACD, and wider angle and required less antiglaucoma medications than those who underwent LPI alone. Performing phaco/IOL weeks to months after the initial LPI did not appear to adversely affect outcomes compared with those of early phaco/IOL.

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Phacoemulsification and endocyclophotocoagulation in uncontrolled glaucoma: Three-year results

Cited by 18 publications

References 9 publications

Results of Combined Endocyclophotocoagulation and Phacoemulsification in Patients of African Descent: A Retrospective Study

Results of Combined Endocyclophotocoagulation and Phacoemulsification in Patients of African Descent: A Retrospective Study

Combined Phacoemulsification and 360-Degree Endocyclophotocoagulation with and without a Kahook Dual Blade in Patients with Primary Open-Angle Glaucoma

Early versus Delayed Phacoemulsification and Intraocular Lens Implantation for Acute Primary Angle-Closure

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