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. 2019 Winter;8(4):257-265.
Epub 2019 Oct 1.

Combined Endocyclophotocoagulation and Phacoemulsification in Patients with Glaucoma of African Descent

Corey W Waldman  1   2 , Manishi Desai  1 , Effie Z Rahman  2 , Babak Eliassi-Rad  1
Affiliations

Combined Endocyclophotocoagulation and Phacoemulsification in Patients with Glaucoma of African Descent

Corey W Waldman et al. Med Hypothesis Discov Innov Ophthalmol. 2019 Winter.

Abstract

The aim of this study was to evaluate the outcomes of combined endocyclophotocoagulation (ECP) and phacoemulsification regarding vision, refraction, intraocular pressure (IOP), medication dependence, and complications in patients of African descent. A retrospective chart review was performed including all cases of ECP combined with phacoemulsification from October 2015 to March 2017. Exclusion criteria consisted of patients who were not of African descent and patients with <1 month follow-up. IOP was the primary outcome. Thirty-two eyes of 29 patients were included in the study. Mean ± standard deviation (SD) of IOP decreased from 17.30 ± 6.30 mmHg preoperatively to 15.88 ± 4.23 mmHg at the last postoperative visit (P = 0.301). In 2 of eight patients who did not demonstrate a difference in pre- and postoperative IOP changes, all IOP lowering medications were stopped. The mean ± SD of follow-up was 5.05 ± 4.08 months with a range of 1 to 18 months. The mean ± SD number of medications used for each patient for IOP control decreased from 2.59 ± 1.01 preoperatively to 1.97 ±1.38 (P = 0.045). Average visual acuity improved from 20/50 preoperatively to 20/25 (P = 0.002). Postoperative complication rate was low. ECP combined with phacoemulsification was effective to decrease IOP lowering medication dependence in patients of African descent. We found that combined ECP and phacoemulsification can lead to a significantly decreased dependence on IOP lowering drops, with some patients demonstrating complete independence from drops following surgery. Although there was not a significant decrease in IOP postoperatively when analyzed collectively, larger studies might to find such an association. Combined ECP and phacoemulsification has been shown to be a safe combination in patients with refractive glaucoma and may be considered if a patient desire less dependence on IOP lowering drops once other first-line methods have failed, or as a bridge between conservative and more definitive surgical treatment.

Keywords: African Continental Ancestry Group; Chronic Angle-Closure Glaucoma; Endocyclophotocoagulation (ECP); Glaucoma; Phacoemulsification; Primary Open-Angle Glaucoma.

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Conflict of interest statement

Ethical issues have been completely observed by the authors. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval for the version to be published. No conflict of interest has been presented.

Figures

Figure 1
Figure 1
Intraoperative View of Ciliary Processes after Laser Ablation Following Endocyclophotocoagulation (ECP)
Figure 2
Figure 2
Intraocular Pressure (IOP) in Millimeters of Mercury (mmHg) over Time
See this image and copyright information in PMC

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