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Combined cataract surgery, ECP lowers pressure in different forms of glaucoma
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CHICAGO — Combining cataract surgery and endocyclophotocoagulation reduces IOP and medication usage in different glaucoma types, with promising results for plateau iris patients, a study found.
"ECP appears to have a unique application to narrow/closed-angle glaucoma, especially in patients with plateau iris, to shrink ciliary processes posteriorly and opening up the anterior chamber angle," Diamond Y. Tam, MD, said here.
Dr. Tam presented results of a retrospective chart review at the American Society of Cataract and Refractive Surgery meeting. He and colleagues examined charts of 101 subjects who underwent endocyclophotocoagulation (ECP) of 270° of ciliary processes along with phacoemulsification and IOL insertion. Patients had primary open-angle glaucoma, chronic angle-closure glaucoma, plateau iris or pseudoexfoliation glaucoma.
Dr. Tam and colleagues found that, at 6 months, the IOP dropped by a mean of approximately 3 mm Hg, from 17.7 mm Hg to 14.5 mm Hg. The average number of topical glaucoma medications used decreased from 2.4 preoperatively to 1.8 postoperatively.
A subgroup analysis of patients with plateau iris found that IOP decreased from 19.1 mm Hg preoperatively to 14.8 mm Hg postoperatively. Glaucoma medications in this group decreased from 1.4 preop to 0.7 postop, Dr. Tam said.
There were no intraocular complications, but postop complications included corneal edema for more than 1 month in four patients, anterior chamber reaction for more than 1 month in four patients, and late branch retinal vein occlusion in one patient, Dr. Tam said. There were no cases of hypotony.