Combined Endoscopic Cyclophotocoagulation and Phacoemulsification Versus Phacoemulsification Alone in the Glaucoma Treatment: A Systematic Review and Meta-Analysis

Abstract

The complete safety and efficacy of endoscopic cyclophotocoagulation (ECP) remain unclear in the literature and, to our knowledge, there are no current meta-analyses on phaco-ECP versus phacoemulsification alone to date. Thus, we conducted a systematic review and meta-analysis comparing these two strategies through studies, assessing the effectiveness and safety of outcomes in a population with glaucoma. The protocol for this systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews (CRD42023482376). We systematically searched PubMed, Embase, and Web of Science from inception to December 2023. A random-effects model was used for all analyses due to heterogeneity. Review Manager 5.3 (Cochrane Centre, The Cochrane Collaboration, Denmark) was used for statistical analysis. Finally, nine studies were included in this comprehensive review and a total of 5389 eyes were analyzed in our study. In comparison to the ECP and phacoemulsification group, those receiving phacoemulsification alone showed better results in best-corrected visual acuity (MD 0.09; CI 95% 0.03 to 0.16; I²=0%), but worse outcomes in intraocular pressure (IOP) (MD -1.49; 95% CI -2.29 to -0.68; I²=29%) and use medications (MD -0.75; 95% CI -0.94 to -0.56; I²=0%) in the last visit. Complication rates, both general and serious, were significantly different between the groups, indicating the potential impact of combined procedures on patient outcomes. Thus, combining ECP with phacoemulsification for glaucoma treatment showed sustained IOP reduction and decreased medication dependence. However, higher complication rates suggest careful consideration of risks. More extensive research with larger trials and longer follow-ups is needed to validate findings and address limitations, providing valuable insights into this treatment approach.

A Morphometric Study of the Pars Plana of the Ciliary Body in Human Cadaver Eyes

“…Alternatively, optical biometry employs optical partial coherence interferometry (PCI) to determine the axial length in vivo, quantifying the distance from the cornea’s anterior surface to the retinal pigment epithelium [ 30 ]. Understanding the pars plana is crucial for various procedures, including cyclophotocoagulation and trabeculectomy, to ensure effective and safe treatment outcomes [ 33 , 34 ].…”

Phaco-Chop versus Divide-and-Conquer in Patients Who Underwent Cataract Surgery: A Systematic Review and Meta-Analysis

“…2 Phacoemulsification is a widely used technique in cataract surgery, introduced by Charles Kelman in 1967, which has become the standard of care due to its safety and efficiency. 3,4 The employment of phacoemulsification techniques with the insertion of a foldable intraocular lens (IOL) is the procedure of choice for treatment, contributing to better outcomes using lower energy and, therefore, less corneal endothelial cell injury due to the amount of intraocular ultrasound energy dispensed. 5 Advancements in cataract surgery technology have increased the efficiency of phacoemulsification.…”