Efficacy of combined cataract extraction and endoscopic cyclophotocoagulation for the reduction of intraocular pressure and medication burden

AIM: To report on the efficacy of combined endoscopic cyclophotocoagulation(ECP) and phacoemulsification cataract extraction(PCE) with intraocular lens placement for reduction of intraocular pressure(IOP) and medication burden in glaucoma.·METHODS: A retrospective case review of 91 eyes(73patients) with glaucoma and cataract that underwent combined PCE/ECP surgery was performed. Baseline demographic and ocular characteristics were recorded,as well as intraocular pressure, number of glaucoma medications, and visual acuity postoperatively with 12-month follow-up. Treatment failure was defined as less than 20% reduction in IOP from baseline on two consecutive visits(at 1, 3, 6, or 12 mo postoperatively),IOP ≥21 mm Hg or ≤5 mm Hg on two consecutive visits, or additional glaucoma surgery performed within12 mo after PCE/ECP.·RESULTS: Overall, mean medicated IOP was reduced from 16.65 mm Hg at baseline to 13.38 mm Hg at 12mo(P <0.0001). Mean number of glaucoma medications was reduced from 1.88 medications at baseline to 1.48 medications at 12mo(P =0.0003). At 3mo postoperatively,the success rate was 73.6%(95%CI: 63.3, 81.5), 57.1% at6mo(95% CI: 46.3, 66.6), and 49.7% at 12mo(95% CI:38.9, 59.6). Patient demographic characteristics were not associated with treatment success. The only ocular characteristic associated with treatment success was a higher baseline IOP.· CONCLUSION: Combined PCE/ECP surgery is an effective surgical option for the reduction of IOP and medication burden in glaucoma patients. Patients withhigher baseline IOP levels are most likely to benefit from this procedure.