July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Intraocular pressure reduction after combined ab interno trabeculotomy and endocyclophotocoagulation in patients with open angle glaucoma
Author Affiliations & Notes
  • Louisa Lu
    Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut, United States
  • Ji Liu
    Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut, United States
  • Footnotes
    Commercial Relationships   Louisa Lu, None; Ji Liu, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 459. doi:
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    • Get Citation

      Louisa Lu, Ji Liu; Intraocular pressure reduction after combined ab interno trabeculotomy and endocyclophotocoagulation in patients with open angle glaucoma. Invest. Ophthalmol. Vis. Sci. 2018;59(9):459.

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

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Abstract

Purpose : The purpose of this study was to investigate the effect of combined ab interno trabeculotomy (AIT, trabectome) and endocyclophotocoagulation (ECP) on lowering intraocular pressure (IOP) in patients with primary open angle glaucoma.

Methods : A retrospective chart review of patients who underwent combined AIT and ECP at the Yale Eye Center since 2014 and had received at least 12 months of follow-up was performed. The clinical records of the patients were reviewed to document and analyze trends in IOP throughout the course of a 12-month follow-up period. Data was collected from post-operative follow-up visits at 6 months, 9 months, and 12 months. A secondary analysis was performed to investigate any contributory effect of the addition of phacoemulsification to AIT/ECP in lowering intraocular pressure.

Results : Chart review identified seven eyes with primary open angle glaucoma or exfoliative glaucoma that underwent combined AIT and ECP and had post-operative follow-up for at least 12 months after the procedure. The average pre-operative IOP for the pseudophakic eyes that underwent AIT/ECP without phacoemulsification was 29.6 ± 2.1 on an average of 1.4 ± 0.5 IOP-lowering eyedrops. At 6 months, 9 months, 12 months, follow-up, there was a 35%, 30%, 30%, reduction in IOP, respectively, from the pre-operative IOP. The average pre-operative IOP for the phakic eyes that underwent AIT/ECP/phacoemulsification was 22.0 ± 3.0 on an average of 2.5 ± 0.5 IOP-lowering eyedrops. At 6 months, 9 months, 12 months follow-up, there was a 23%, 18%, 39%, reduction in IOP, respectively, from the pre-operative IOP.

Conclusions : The study suggests that combined AIT/ECP in glaucoma patients has a significant effect on IOP reduction at an extended follow-up period of 12 months, with a potentially synergistic benefit compared to either procedure alone. The addition of phacoemulsification to the combined AIT/ECP procedure may have a contributory effect in further lowering IOP in phakic eyes, following a delay of approximately 12 months post-operation. Performing combined trabectome/ECP with or without the addition of phacoemulsification may thus be a noteworthy procedural technique in glaucoma patients.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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