Outcome of Combined Phacoemulsification and Endocyclophotocoagulation in Glaucoma

Abstract

 

Purpose

 

To evaluate the outcome of combined phacoemulsification and endocyclophotocoagulation in glaucoma

 

Methods

 

209 eyes of 189 patients who undewent combined phaco-ECP and had a minimum followup of one year were included in this retrospective cohort study.The main outcome measures were the reduction in the intraocular pressure, the change in the number of antiglaucoma medications and the rate of postoperative complications. Kaplan-Meier survival analysis was performed.

 

Results

 

Compared to a mean preoperative pressure of 17.9 mmHg, the IOP decreased by 3, 2 and 1.5 mmHg on 12, 24 and 36 months of followup.The number of antiglaucoma medications decreased by one over 36 months. The cumulative probability of success was 87.7%, 77.4% and 60.0% on 12, 24 and 36 months postoperatively. There was a slightly positive correlation between the preoperative and postoperative IOP (Spearman's= 0.13, p=0.04). The most common complications were fibrinous reaction (21 eyes, 10%), IOP spikes > 30 mmHg (21 eyes, 9.6%) and hyphema (2 eyes, 1%). 7 eyes (3.3%) needed a second glaucoma procedure to control the pressure: 3 shunts, 2 Trabeculectomies and 2 trans-scleral cycloablations.

 

Conclusions

 

Phaco-ECP offers a reasonable IOP control with less medications especially on the short term even for eyes that failed filtration procedure. Postoperative complications were few and transient. A small proportion of patients needed a second glaucoma procedure to control the pressure.

 

 

Kaplan-Meier survival curve show that the cumulative survival was 87.3%, 77.4% and 69.0% on 12, 24 and 36 months respectively.

 

 

Density scatterplot showing slightly positive correlation between the preoperative and postoperative IOP (ρ=0.13, p=0.04). Dashed red line show the mean preoperative IOP while dashed green line show the final mean IOP.

 

Keywords: 568 intraocular pressure • 578 laser • 445 cataract