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Phacoemulsification plus endoscopic cyclophotocoagulation versus phacoemulsification alone in primary open-angle glaucoma

Abstract

Purpose

To examine the efficacy and safety of combined phacoemulsification and endoscopic cyclophotocoagulation (phaco-ECP) compared to phacoemulsification alone in patients with primary open-angle glaucoma (POAG).

Methods

We performed a retrospective notes review of 99 consecutive clinical records of patients with POAG from 2 London eye departments. A total of 69 patients who underwent phaco-ECP and 30 sex- and age-matched control patients who underwent cataract surgery alone were included. Data on intraocular pressure (IOP), visual acuity (VA), number of ocular hypotensive medications, and postoperative complications were collected over 12 months. The primary outcome measure was defined as an IOP within normal limits (<21 mm Hg) and at least a 20% reduction in IOP from baseline.

Results

Mean IOP was significantly decreased in both groups after 1 year (p<0.001 from baseline). The success rate was significantly higher in the phaco-ECP group (69.6%) than in the phaco group (40%) after 1 year (p = 0.004). Reduction in mean IOP and number of medications was also greater in the phaco-ECP group after 1 year (IOP reduction: 4.5 ± 5.13 mm Hg vs 1.83 ± 3.61 mm Hg; p = 0.007; number of medications reduction: 0.73 ± 0.71 vs 0.23 ± 0.56; p = 0.001). Both groups achieved a similar improvement in VA. There was a higher incidence of minor and self-limiting complications in the phaco-ECP group (p<0.047).

Conclusions

Phaco-ECP resulted in a greater reduction in IOP and number of medications than phacoemulsification alone in POAG.

Post author correction

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/ejo.5001034

Authors

Francisco Pérez Bartolomé, Ian A. Rodrigues, Saurabh Goyal, Edward Bloch, Wei S. Lim, Pouya Alaghband, Jose Guajardo, Stephanie Jones, Kin S. Lim

Article History

Disclosures

Financial support: No financial support was received for this submission.
Conflict of interest: None of the authors has conflict of interest with this submission.
Meeting presentation: Presented at the World Glaucoma Congress, Helsinki, June 28-July 1, 2017.

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Authors

Affiliations

  •  Department of Ophthalmology, Hospital Clínico San Carlos, Madrid - Spain
  •  Department of Ophthalmology, St. Thomas’ Hospital NHS Foundation Trust, London - UK
  •  Department of Ophthalmology, King’s College Hospital NHS Foundation Trust, London - UK

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