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Presentation Abstract
Program#/Poster#:
2633/A74
Abstract Title:
The Long-term Efficacy Of Combined Endoscopic
Cyclophotocoagulation (ECP) And Phacoemulsification In The
Treatment Of Mild-moderate Glaucoma
Presentation Start/End
Time:
Tuesday, May 03, 2011, 8:30 AM -10:15 AM
Session Number:
311
Session Title:
Glaucoma Lasers and Aqueous Drainage Devices
Location:
Hall B/C
Reviewing Code:
236 glaucoma: surgery or wound healing - GL
Author Block:
Omar S. Faridi1, Michael J. Siegel2, Chirag K. Gupta1, Joseph C.
Neilitz3, Matthew E. Citron1,4, Marc J. Siegel1,4, Les I. Siegel1,4.
1
Ophthalmology, William Beaumont Hospital, Royal Oak, MI; 2Kresge Eye
Institute, Wayne State University, Detroit, MI; 3Ophthalmology, St. John
Providence Hospital-Michigan State University, Madison Heights, MI;
4
Glaucoma, Glaucoma Center of Michigan, Southfield, MI.
Keywords:
567 intraocular pressure; 462 clinical (human) or epidemiologic studies:
outcomes/complications; 457 ciliary processes
Abstract Body:
Purpose: To evaluate the long-term efficacy of combined endoscopic
cyclophotocoagulation (ECP) and phacoemulsification in the treatment of
mild-moderate glaucoma.
Methods: Retrospective non-comparative non-industry sponsored
interventional case series at one center with procedures performed by three
glaucoma trained surgeons from 2004-2007. Patients were excluded if they
had severe glaucoma or had prior phacoemulsification, cyclodestructive,
filtering, or tube-shunt procedures. Utilizing IOP, glaucoma medication use,
and complications as main outcome measures, evaluation was performed
from baseline up to 66 months. Bonferroni’s adjustment was made for the
multiple comparisons performed to baseline IOP.
Results: The mean baseline IOP in 187 eyes of 111 patients was 17.69 ±
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0.35 (SE) mmHg (range 8.0-45.00; median 17.00), 15.18 ± 0.43 at month
12 (n=157; P <0.0001), 15.06 ± 0.32 at month 24 (n=157; P <0.0001),
14.81 ± 0.29 at month 36 (n=132; P <0.0001), 14.94 ± 0.41 at month 48
(n=52; P=0.012), 13.93 ± 0.6 at month 54 (n=30; P=0.005), 14.87 ± 0.52
at month 60 (n=15; P=1.000). The baseline mean number of glaucoma
medications was 0.87 ± 0.04 (SE) (median 1.00; range 0-3) and 0.33 ± 0.17
at month 60. The mean IOP significantly changes with an average
reduction of 14.57% ± 1.78. The likelihood of sustained IOP control
without the use of glaucoma medications is significant at every time point
showing that patients were 7.78 times as likely to have no glaucoma
medications at 12 months, 8.07 at 24 months, 8.45 at 36 months, 21.37 at
48 months, and 65.42 times more likely to be without glaucoma
medications at 60 months (all P<0.0001). Subsequent secondary glaucoma
procedures were performed in 9 patients, including 7 selective laser
trabeculoplasties, 2 laser peripheral iridotomies, 2 trabeculectomies, 1 tube
shunt, and 1 diode laser. Cystoid macular edema occurred in 3 patients,
successfully treated in 2 patients with one lost to follow-up. One patient
required a penetrating keratoplasty.
Conclusions: The use of ECP and phacoemulsification in mild-moderate
glaucoma safely and effectively lowers IOP and the dependence on
glaucoma medications up to five years. This combination procedure may in
turn lead to less financial burden and adverse effects associated with
glaucoma drops.
CommercialRelationships: Omar S. Faridi, None; Michael J. Siegel, None; Chirag K. Gupta,
None; Joseph C. Neilitz, None; Matthew E. Citron, None; Marc J.
Siegel, None; Les I. Siegel, None
Support:
None
©2011, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to www.iovs.org to
access the version of record. For permission to reproduce any abstract, contact the ARVO Office at [email protected].
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