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. 2019 Feb 25;2(2):CD012741.
doi: 10.1002/14651858.CD012741.pub2.

Endoscopic cyclophotocoagulation (ECP) for open angle glaucoma and primary angle closure

Márta Tóth  1 , Anupa Shah, Kuang Hu, Catey Bunce, Gus Gazzard
Affiliations

Endoscopic cyclophotocoagulation (ECP) for open angle glaucoma and primary angle closure

Márta Tóth et al. Cochrane Database Syst Rev. .

Abstract

Background: Glaucoma is a leading cause of irreversible blindness. A number of minimally invasive surgical techniques have been introduced as a treatment to prevent glaucoma progressing. Among them, endoscopic cyclophotocoagulation (ECP) is a cyclodestructive procedure developed by Martin Uram in 1992.

Objectives: To evaluate the efficacy and safety of ECP in people with open angle glaucoma (OAG) and primary angle closure whose condition is inadequately controlled with drops.

Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2018, Issue 6); Ovid MEDLINE; Ovid Embase; the ISRCTN registry; ClinicalTrials.gov and the WHO ICTRP. The date of the search was 12 July 2018.

Selection criteria: We searched for randomised controlled trials (RCTs) of ECP compared to other surgical treatments (other minimally invasive glaucoma device techniques, trabeculectomy), laser treatment or medical treatment. We also planned to include trials where these devices were combined with phacoemulsification compared to phacoemulsification alone.

Data collection and analysis: Two review authors planned to independently extract data from reports of included studies using a data collection form and analyse data based on methods expected by Cochrane. Our primary outcome was proportion of participants who were drop-free (not using eye drops). Secondary outcomes included mean change in IOP; proportion of participants who achieved an IOP of 21 mmHg or less, 17 mmHg or less or 14 mmHg or less; and proportion of participants experiencing intra- and postoperative complications, We planned to measure all outcomes in the short-term (six to 18 months), medium-term (18 to 36 months), and long-term (36 months onwards).

Main results: We found one ongoing study that met our inclusion criteria (ChiCTR-TRC-14004233). The study compares combined phacoemulsification with ECP to phacoemulsification alone in people with primary angle closure glaucoma. The primary outcome is intraocular pressure (IOP) and number of IOP-lowering drugs. A total of 50 people have been enrolled. The study started in February 2014 and the trialists have completed recruitment and are in the process of collecting data.

Authors' conclusions: There is currently no high-quality evidence for the effects of ECP for OAG and primary angle closure. Properly designed RCTs are needed to assess the medium and long-term efficacy and safety of this technique.

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Conflict of interest statement

The authors are seeking funding to address the subject of this review.

MT: none known AS: none known KH has lectured on 'Constructing clinical trials for MIGS – the lack of evidence and what to do about it' at the Moorfields International Glaucoma Symposium 2016, sponsored by Laboratoires Thea, which is contributing an educational grant to Moorfields Eye Hospital. CB: none known GG has since 2012 received travel funding and from his host organisation received both educational and unrestricted research funding from pharmaceutical and equipment manufacturers that are involved in the treatment of glaucoma but none that are otherwise related to the subject of this report.

Figures

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Study flow diagram.
See this image and copyright information in PMC

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References

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ChiCTR‐TRC‐14004233 {published data only}
    1. ChiCTR‐TRC‐14004233. Combined phacoemulsification‐endoscopic cyclophotocoagulation versus phacoemulsification alone in primary angle‐closure glaucoma: a randomized controlled trial. www.chictr.org.cn/showprojen.aspx?proj=5335 Date first received: 2 April 2014.

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Tóth 2017
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