Two-site endoscopic cyclophotocoagulation lowers IOP more than one-site surgery

Performing endoscopic cyclophotocoagulation combined with phacoemulsification through two clear corneal incisions may lower IOP significantly more than surgery performed through a single incision, a retrospective study suggests. Using two incisions may also reduce postoperative dependence on glaucoma medications, the authors noted.

Malik Y. Kahook, MD, and colleagues compared outcomes for patients treated with endoscopic cyclophotocoagulation and phacoemulsification through one or two clear corneal incisions. They published their results in the September issue of Journal of Glaucoma.

Both groups were similar in age, preop diagnoses and preop IOP, according to the study.

The single-incision group included 15 patients who averaged 66.07 years of age. Preoperatively, visual acuity ranged from 20/40 to 20/400 and IOP averaged 23.6 mm Hg.

The two-incision group included 25 patients who averaged 73.48 years of age. Preoperatively, visual acuity ranged from 20/40 to counting fingers and IOP averaged 24.48 mm Hg.

At 3 months follow-up, IOP was significantly lower in the two-incision group compared with the single-incision group. Mean IOP had decreased to 17.93 mm Hg in the single-incision group (P = .0008) and 13.88 mm Hg in the two-incision group (P = .00001), the authors reported.

At 6 months, IOP remained significantly lower in the two-incision group and averaged 13 mm Hg compared with 16 mm Hg in the single-incision group (P = .04), according to the study.

The two-incision group also had a greater decrease in use of glaucoma medications. Preoperatively, the two-incision group used an average of 2.56 glaucoma drugs, which fell to 0.52 drugs postoperatively. The single-incision group used an average of 2.47 glaucoma drugs preoperatively, which decreased to 1.93 drugs after surgery.