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Phaco and Endoscopic Cyclophotocoagulation

Endoscopic Cyclophotocoagulation Combined with Phacoemulsification Vs. Phacoemulsification Alone in Medically Controilled Glaucoma 

Brian Francis, MD; Stanley J. Berke, MD; Robert Noecker, MD

Doheny Eye Institute, University of California, Los Angles, CA, USA


The purpose of this study was to determine whether combining ECP with phacoemulsification in the setting of cataract and medically controlled glaucoma results in a long-term decrease in IOP and/or in the number of glaucoma medications required compared with phacoemulsification alone. 


In an effort to answer this question, a prospective non-randomized matched-control study with a large patient cohort and extended post surgical follow-up was performed. 



Endoscopic cyclophotocoagulation added to cataract extraction resulted in greater reduction in IOP and glaucoma medications than cataract extraction alone over a 3-year period.

Phaco/ECP: Combined Endoscopic Cyclophotocoagulation and Cataract Surgery to Augment Medical Control of Glaucoma 

Dan Lindfield, MD; Robert W Ritchie, MD; Maj. Michael FP Griffiths, MD

Frimley Park Hospital, Camberley, Surrey, UK


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This study, reported by the British Medical Journal in October 2012 details the effect of Phaco/ECP in augmenting medical control of glaucoma.

In the 58 patients reported on, had a mean intraocular pressure of a mean intraocular pressure 21.54 mm Hg (95% CI 19.86 to 23.22, n1⁄456). 

Mean IOP was 14.43 mm Hg (95% CI 13.65 to 15.21, n1⁄453) at 18 months and 14.44 mm Hg (95% CI 13.63 to 15.25, n1⁄441) at 24 months. 
The mean drop from baseline to 18 and 24 months was 7.1 mm Hg. (33% reduction).  Statistically significant decrease in IOP was demonstrated at all time points (p<0.001). 

As the purpose of the study was to show the pressure lowering effects of ECP alone, (without modifying medications, 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.

There were no cases of hyphaema, hypotony, lens instability or dislocation, cystoid macular oedema, retinal tears or endophthalmitis. 
 

To view and download the following useful articles describing ECP techniques, and the utility in managing moderate to advanced glaucoma, please click on the corresponding icon below.
 
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Marc Weston, MD - ECP Surgical Technique