Dataset Information

'Phaco-ECP': combined endoscopic cyclophotocoagulation and cataract surgery to augment medical control of glaucoma.

ABSTRACT:

Objectives

Does phaco-ECP reduce intraocular pressure? Is phaco-ECP safe?

Design

Retrospective case note review of all patients undergoing phaco-ECP between June 2008 and June 2009. All glaucoma subtypes were included.

Setting

Single District General Hospital Ophthalmology Department within the UK.

Participants

58 participants case notes reviewed. Mean age 79.0 years (SD ±9.8).

Interventions

All patients received combined cataract surgery and endoscopic cyclophotocoagulation.

Outcome measures

Follow-up was 1 day, 1 week, 1, 3, 6, 12, 18 and 24 months for intraocular pressure (IOP) measurement. Number of medications, visual acuity and presence of complications were also assessed.

Results

Of the 58 cases performed, 56 case notes (97%) were available for analysis. Mean age 79.0 years (SD ±9.8). Mean pre-procedural IOP was 21.54 mm?Hg (95% CI 19.86 to 23.22, n=56). Mean IOP was 14.43 mm?Hg (95% CI 13.65 to 15.21, n=53) at 18 months and 14.44 mm?Hg (95% CI 13.63 to 15.25, n=41) at 24 months. The mean drop from baseline to 18 and 24 months was 7.1 mm?Hg. Statistically significant decrease in IOP was demonstrated at all time points (p<0.001). Mean medication usage was 1.97 agents (95% CI 1.69 to 2.25) at baseline, 1.96 agents (95% CI 1.70 to 2.22) at 18 months and 2.07 agents (95% CI 1.76 to 2.38) at 24 months. No statistically significant change throughout.

Conclusions

This study confirms the safety of phaco-ECP. In this case series, the IOP-lowering effect was significant at all time points; however, the effect of cataract surgery alone was not controlled. A randomised controlled trial is required to draw efficacy conclusions. The authors proposed endoscopic cyclophotocoagulation's main role is to optimise control of low-risk glaucoma of low-risk patients at the time of cataract surgery. However, the authors do not propose that phaco-ECP is a substitute for filtration surgery in high-risk eyes or when low target pressures (<14 mm?Hg) are indicated.

SUBMITTER: Lindfield D

PROVIDER: S-EPMC3367146 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

'Phaco-ECP': combined endoscopic cyclophotocoagulation and cataract surgery to augment medical control of glaucoma.

Lindfield Dan D Ritchie Robert W RW Griffiths Michael Fp MF

BMJ open 20120530 3

<h4>Objectives</h4>Does phaco-ECP reduce intraocular pressure? Is phaco-ECP safe?<h4>Design</h4>Retrospective case note review of all patients undergoing phaco-ECP between June 2008 and June 2009. All glaucoma subtypes were included.<h4>Setting</h4>Single District General Hospital Ophthalmology Department within the UK.<h4>Participants</h4>58 participants case notes reviewed. Mean age 79.0 years (SD ±9.8).<h4>Interventions</h4>All patients received combined cataract surgery and endoscopic cyclop ...[more]

PMID: 22649172

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Dataset Information

'Phaco-ECP': combined endoscopic cyclophotocoagulation and cataract surgery to augment medical control of glaucoma.

Objectives

Design

Setting

Participants

Interventions

Outcome measures

Results

Conclusions

Publications

'Phaco-ECP': combined endoscopic cyclophotocoagulation and cataract surgery to augment medical control of glaucoma.

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