Phaco-ECP vs. Phaco alone to treat glaucoma
Reviewed by Anjali Gupta

This retrospective review compared combined phacoemulsification and endoscopic cyclophotocoagulation (phaco-ECP) to phaco alone in patients with mild to moderate glaucoma. Outcome measures included cumulative full and qualified success survival, postintervention IOP and ocular anti-hypertensive medication reduction. Full success was defined as a minimum of 20% reduction of IOP with a decrease in at least one ocular anti-hypertensive medication, qualified success was defined as an IOP no higher than preoperative with a decrease in at least one ocular anti-hypertensive medication. There were 261 eyes in the phaco-ECP group and 52 eyes in the phaco alone group. All patients were diagnosed with mild to moderate glaucoma controlled medically preoperatively with one to three ocular anti-hypertensive medications. Results showed that both phaco-ECP and phaco alone effectively lowered the IOP in the long-term when compared to baseline. At 36 months, the mean number of medication reliance in the phaco-ECP group was 0.2 compared to 1.3 in the phaco alone group; 61.4% reached full success in the phaco-ECP group compared to 23.3% in the phaco alone group. In the phaco-ECP group 72.6% reach qualified success compared to 23.3% in the phaco alone group. All these results were statistically significant. Complications that occurred in the phaco-ECP group included cystoid macula oedema (four cases), retinal detachment (two cases), the need for secondary glaucoma procedures (seven cases) and the need for a penetrating keratoplasty (one case). In conclusion, combined phaco-ECP is more effective in treating mild to moderate glaucoma when compared to phaco alone.

Combined endoscopic cyclophotocoagulation and phacoemulsification versus phacoemulsification alone in the treatment of mild to moderate glaucoma.
Siegel MJ, Boling WS, Faridi OS, et al.
CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
2015;43:531-9.