Objective
To assess the safety and efficacy of endocyclophotocoagulation with phacoemulsification (phaco-ECP) in surgically naive, primary open-angle glaucoma (POAG).
Methods
A retrospective case series of patients undergoing phaco-ECP between 2007 and 2017 at a single centre in London, UK. The primary outcome was intraocular pressure (IOP). Secondary outcomes were visual acuity, visual field global indices, topical medications and surgical complications. Failure criteria were: (1) IOP > 21 mmHg or <20% reduction at two consecutive visits, (2) IOP <5 mmHg and (3) further IOP-lowering surgery.
Results
Eighty-three eyes from 83 patients were eligible. Pre-operatively, mean IOP (±SD) was 18.4 ± 5.2 mmHg. The mean number of topical agents (±SD) was 2.7 ± 0.9. Mean IOP (±SD) significantly reduced to 14.3 ± 4.7 at 1 year, 14.1 ± 4.0 at 2 years and 13.6 ± 3.7 at 3 years (p < 0.0001). Topical medications were significantly reduced to 1.3 ± 1.2 at 1 year, 1.7 ± 1.2 at 2 years and 1.8 ± 1.3 at 3 years (p < 0.0001). Annual IOP ‘survival’ was 70%, 54% and 45% at year 1, 2 and 3, respectively. Complications included uveitis (6%), macular oedema (2%), IOP spikes (1%) and corneal decompensation (1%) with no episodes of hypotony or retinal detachment. One patient underwent filtration surgery within 3 years (1%).
Conclusion
Phaco-ECP facilitates significant IOP lowering and reduction of medication burden in surgically naive POAG requiring cataract extraction. The procedure is relatively safe and without the use of implants and their associated risks.
The goal of this study is to assess the effect of pupillary dilation on predicted post-operative refraction (the Plano or least minus refraction) and on recommended intraocular lens (IOL) power calculated by using the third generation and fourth generation formula to measure the difference between pre and post pupil dilation on ACD. This study included 40 eyes with cataract will undergo phacoemulsification and divided into two group Group (A): 20 cataract patients with biometry by third formula (SRK/T and Hoffer Q). Group (B): other 20 cataract patients with biometry by fourth formula (Holladay 2). There were statically non-significant differences found between PPR before and after pupil dilation in Group A and Group B with p value 0.861and 0.181 respectively. The main age of our patient in group A ranged from (21-42) years and age ranged from (25 to 45) in group B with statically non-significant differences between two groups.
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