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