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Combined endoscopic cyclophotocoagulation and phacoemulsification versus phacoemulsification alone in the treatment of mild to moderate glaucoma
Author(s) -
Siegel Michael J,
Boling Whitney S,
Faridi Omar S,
Gupta Chirag K,
Kim Chaesik,
Boling Richard C,
Citron Matthew E,
Siegel Marc J,
Siegel Les I
Publication year - 2015
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/ceo.12510
Subject(s) - phacoemulsification , medicine , intraocular pressure , glaucoma , ophthalmology , surgery , visual acuity
Background To evaluate the long‐term effects of combined endoscopic cyclophotocoagulation and phacoemulsification (phaco) versus phacoemulsification alone on intraocular pressure control and medication reliance in the treatment of mild to moderate glaucoma. Design Retrospective chart review in private practice setting by glaucoma fellowship trained surgeons. Participants A total of 261 eyes in the combined phaco‐endoscopic cyclophotocoagulation group with 52 eyes in the phaco‐alone group. Methods Comparison of phaco‐endoscopic cyclophotocoagulation with phaco alone over 36 months. Main Outcome Measures Full and qualified success cumulative survival, intraocular pressure and medication reliance 6–36 months compared with baseline. Full success was defined as minimum 20% intraocular pressure reduction with a decrease of at least one ocular hypertensive medication. Qualified success was defined as intraocular pressure no higher than baseline with a decrease of at least one ocular hypertensive medication. Results At 36 months, mean intraocular pressure in the combined phaco‐endoscopic cyclophotocoagulation group was 14.6 mmHg, whereas the phaco‐alone group was 15.5 mmHg ( P = 0.34). Mean medication reliance in the combined phaco‐endoscopic cyclophotocoagulation group was 0.2 medications, whereas the phaco‐alone group was 1.2 ( P < 0.001). Full success in the phaco‐endoscopic cyclophotocoagulation group was 61.4%; the phaco‐alone group was 23.3% ( P < 0.001). Qualified success survival was 72.6% in the phaco‐endoscopic cyclophotocoagulation group and 23.3% in the phaco‐alone group ( P < 0.001). Conclusions Combined phaco‐endoscopic cyclophotocoagulation effectively lowers or maintains intraocular pressure and results in ocular hypertensive medication reduction up to 36 months when compared with phaco alone. Therefore, phaco‐endoscopic cyclophotocoagulation may help to increase medication compliance and reduce glaucoma progression in mild to moderate glaucoma.