March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
The Effects Of Combined Endoscopic Cyclophotocoagulation (ECP) And Phacoemulsification In The Treatment Of Mild to Moderate Glaucoma
Author Affiliations & Notes
  • Michael J. Siegel
    Ophthalmology, Kresge Eye Institute, Detroit, Michigan
  • Wen-Shi Shieh
    School of Medicine, Wayne State University, Detroit, Michigan
  • Omar S. Faridi
    Ophthalmology, William Beaumont Hospital, Royal Oak, Michigan
  • Chirag K. Gupta
    Ophthalmology, Beaumont, Bloomfield Hills, Michigan
  • Mark S. Juzych
    Ophthalmology, Kresge Eye Institute, Detroit, Michigan
  • Matthew E. Citron
    Glaucoma Center of Michigan, Southfield, Michigan
  • Marc J. Siegel
    Glaucoma Center of Michigan, Southfield, Michigan
  • Les I. Siegel
    Glaucoma Center of Michigan, Southfield, Michigan
  • Footnotes
    Commercial Relationships  Michael J. Siegel, None; Wen-Shi Shieh, None; Omar S. Faridi, None; Chirag K. Gupta, None; Mark S. Juzych, None; Matthew E. Citron, None; Marc J. Siegel, None; Les I. Siegel, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 5982. doi:
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      Michael J. Siegel, Wen-Shi Shieh, Omar S. Faridi, Chirag K. Gupta, Mark S. Juzych, Matthew E. Citron, Marc J. Siegel, Les I. Siegel; The Effects Of Combined Endoscopic Cyclophotocoagulation (ECP) And Phacoemulsification In The Treatment Of Mild to Moderate Glaucoma. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5982.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To evaluate the effects of combined endoscopic cyclophotocoagulation (ECP) and phacoemulsification in the treatment of mild to moderate glaucoma.

Methods: : Retrospective, non-comparative, non-industry sponsored interventional case series at one center with procedures performed by three glaucoma trained surgeons from 2004-2010. Main outome measures included intraocular pressure, glaucoma medication use and complications. Patients were excluded if they had severe glaucoma, prior phacoemulsification, cyclodestructive, filtering, or tube-shunt procedures. Evaluation was performed from baseline up to 72 months.

Results: : The mean baseline IOP in 337 eyes of 188 patients was 16.79 ± 0.35 (SE) mmHg (range 8.0-45.00; median 17.00), 15.18 ± 0.43 at month 12 (n=212; P <0.0001), 15.06 ± 0.32 at month 24 (n=189; P <0.0001), 14.81 ± 0.29 at month 36 (n=149; P <0.0001), 14.94 ± 0.41 at month 48 (n=72; P=0.012), 13.93 ± 0.6 at month 54 (n=37; P=0.005), 14.87 ± 0.52 at month 60 (n=26; P=0.05), 14.66 ± 0.63 at month 72 (n=17; P=1.000). The mean IOP significantly changes with an average reduction of 16.32% ± 1.33. The baseline mean number of glaucoma medications was 0.95 ± 0.04 (SE) (median 1.00; range 0-3) and 0.29 ± 0.12 at month 72. Subsequent secondary glaucoma procedures were performed in 15 patients, including 10 selective laser trabeculoplasties, 2 laser peripheral iridotomies, 2 trabeculectomies, 1 tube shunt, and 1 diode laser. Cystoid macular edema occurred in 3 patients, successfully treated in 2 patients with one lost to follow-up. One patient required a penetrating keratoplasty.

Conclusions: : The use of ECP and phacoemulsification in mild to moderate glaucoma safely and effectively lowers IOP. More importantly, it lowers the dependence on glaucoma medications up to seventy-two months. Thus, the use of ECP in conjunction with Phacoemulsification may greatly reduce the financial burden and adverse effects, as well as improve the copmliance associated with the use of anti-hypertensive medications.

Keywords: ciliary processes • intraocular pressure • quality of life 
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