Comparison between pars plana and anterior endoscopic cyclophotocoagulation for the treatment of glaucoma

Feinstein, Max; Lee, Jun H.; Amoozgar, Behzad; Liu, Kelsey; Stewart, Jay M.; Lazcano‐Gomez, Gabriel; Porco, Travis C.; Han, Ying

doi:10.1111/ceo.13501

Cited by 8 publications

(9 citation statements)

References 21 publications

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“…The cumulative success rate at 1 year was 48% in our Kaplan-Meier survival curve, which is lower than other studies (78% by Tan et al [9] and 85% by Feinstein et al [22]). In Kaplan-Meier survival curve of these studies, short-term post-op IOP of 1 day, 1 week, and 2 weeks were not included.…”

Section: Plos Onecontrasting

confidence: 75%

“…Feinstein et al compared treatment outcomes between ECP-plus and anterior ECP. [22] Their results found that patients who underwent ECP-plus achieved a higher IOP stabilized rate at 2 years postoperatively (80% vs 33.3%, P < 0.001), along with a greater IOP decrease in the ECP-plus group when compared to the anterior ECP group (14.3 mmHg (52%) vs 5.2 mmHg (24%), P = 0.001).…”

Section: Plos Onementioning

confidence: 95%

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Combined Endoscope assisted Procedures (CEaP) as a complete treatment for neovascular glaucoma

2020

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Section: Plos Onecontrasting

confidence: 75%

Section: Plos Onementioning

confidence: 95%

Combined Endoscope assisted Procedures (CEaP) as a complete treatment for neovascular glaucoma

2020

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“… The approach used: to date, only one study has compared the anterior and posterior approaches (Feinstein et al 2019): the posterior approach led to a lower IOP, a closer IOP control (IOP < 15 mmHg at the last follow‐up), a reduced number of glaucoma medications and a higher success rate after up to 2 years of follow‐up. These findings persisted after adjustment for other confounding factors such as the degree of treatment, preoperative values and whether or not ECP was combined with phacoemulsification.…”

Section: Cw‐tscpc and Ecpmentioning

confidence: 99%

An update on continuous‐wave cyclophotocoagulation (CW‐CPC) and micropulse transscleral laser treatment (MP‐TLT) for adult and paediatric refractory glaucoma

Souissi¹,

Mer²,

Metge³

et al. 2020

Acta Ophthalmologica

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Purpose Continuous‐wave cyclophotocoagulation (CW‐CPC) is often preferred to medical and surgical treatments for managing refractory glaucoma. This review summarizes diode CW‐CPC indications, history, histopathology, methods, efficacy and safety. It also provides an overview of the latest data available on micropulse transscleral laser treatment (MP‐TLT) that uses repetitive micropulses of diode laser energy in an off‐and‐on cyclical fashion. Methods A literature review was conducted on transscleral CW‐CPC (CW‐TSCPC), endoscopic CPC (ECP) and MP‐TLT. Relevant series of adult and paediatric patients were included for assessing the procedures. Results Regarding CW‐TCPC, highly variable success rates are reported in the literature, depending on the definition of success, type of underlying glaucoma, energy settings, follow‐up duration and retreatment rates. CW‐CPC often needs to be repeated, especially in paediatric patients. CW‐CPC exposes to risks of inflammation and chronic ocular hypotony or phthisis with irreversible visual loss. CW‐TSCPC has mainly been used in very severe forms of glaucoma, in painful eyes with limited visual potential or after filtering surgery failure. Published data on ECP are more limited but overall good success rates have been reported. Through the direct visualization of the targeted ciliary body in anatomically abnormal eyes, ECP is the preferred surgical procedure in paediatric refractory glaucoma. Complication rates are relatively low after ECP; however, large studies with long‐term follow‐up are needed. ECP may be used in difficult, refractory cases, but it is often used earlier when combined with cataract surgery. Despite limited data on the exact mechanism of action of MP‐TLT and a lack of standardization of laser settings, the first data from heterogeneous case series shows that it has a similar efficacy and a better safety profile compared to CW‐TSCPC in the medium term. Conclusion Although they may lead to sight‐threatening complications, both CW‐TSCPC and ECP seem effective. ECP appears to be superior to CW‐TSCPC in paediatric refractory glaucoma. Unlike ECP combined with cataract surgery, evidence supporting a wider use of CW‐TSCPC and MP‐TLT in earlier stages of neuropathy is lacking. While it now appears that the safety profile of MP‐TLT is superior to that of CW‐CPC, robust prospective comparative studies including homogeneous and well‐defined cohorts of patients are still needed to confirm an at least comparable efficacy in the long term.

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“…1 In a human study with a 2-year follow-up, pars plana ECP combined with phacoemulsification and IOL placement achieved superior IOP control, and patients were maintained on fewer glaucoma medications compared to those that underwent an anterior ECP approach. 2 To date, there are no published reports of pars plana ECP for the treatment of refractory glaucoma in canine patients. In this case report, we describe successful IOP control with vision preservation with an ECP pars plana approach in a refractory glaucoma patient that previously underwent phacoemulsification and goniovalve implantation in both eyes.…”

Section: Introductionmentioning

confidence: 99%

“…This provides a more thorough treatment and has been significantly effective in human patients in which IOP reduction has been refractory despite prior glaucoma surgeries 1 . In a human study with a 2‐year follow‐up, pars plana ECP combined with phacoemulsification and IOL placement achieved superior IOP control, and patients were maintained on fewer glaucoma medications compared to those that underwent an anterior ECP approach 2 …”

Section: Introductionmentioning

confidence: 99%

Endocyclophotocoagulation by pars plana approach in the management of refractory glaucoma with prior phacoemulsification and Ahmed gonioimplantation in a dog

Kaminsky

Hoffman

Konrade

2022

Veterinary Ophthalmology

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Purpose To describe successful intraocular pressure control of refractory glaucoma and vision preservation with an endocyclophotocoagulation (ECP) procedure by pars plana approach. Animal Studied An 8‐year‐old, female‐spayed, mixed‐breed goniodysgenic dog with glaucoma following phacoemulsification with intraocular lens placement (IOL) refractory to maximized medical therapy and Ahmed gonioimplantation in both eyes (OU). Procedures For the first glaucoma interventional surgery, bilateral goniovalve implantation was performed following cataract surgery. A goniovalve was implanted in the left eye (OS) 2‐days post‐phacoemulsification, and 14‐days post‐phacoemulsification in the right eye (OD). Short‐term intraocular pressure (IOP) control was achieved. However, glaucoma recurred 41‐days post‐phacoemulsification OU, and an endocyclophotocoagulation by pars plana approach was performed OU to treat 300° of the ciliary body with a 23‐gauge argon laser endoscope. Results Th ECP pars plana approach was successful in obtaining IOP‐control and vision preservation during a 15‐month follow‐up period. No intraoperative complications were encountered. Short‐term postoperative complications included intraocular inflammation with fibrin and postoperative ocular hypertension. Intraocular pressure‐control and vision preservation were maintained at the last follow‐up examination, 15 months postoperative pars plana ECP. Conclusion Endocyclophotocoagulation by pars plana approach achieved long‐term (>1 year) IOP‐control, preserved vision, and reduced the number of anti‐glaucoma medications following failure of previous Ahmed gonioimplantation for uncontrolled glaucoma. This is the first case report of an endocyclophotocoagulation procedure by a pars plana approach for uncontrolled glaucoma following Ahmed gonioplantation. With the appropriate skill set, this novel surgical approach can be considered as a surgical intervention for glaucoma in canine patients.

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Comparison between pars plana and anterior endoscopic cyclophotocoagulation for the treatment of glaucoma

Cited by 8 publications

References 21 publications

Combined Endoscope assisted Procedures (CEaP) as a complete treatment for neovascular glaucoma

Combined Endoscope assisted Procedures (CEaP) as a complete treatment for neovascular glaucoma

An update on continuous‐wave cyclophotocoagulation (CW‐CPC) and micropulse transscleral laser treatment (MP‐TLT) for adult and paediatric refractory glaucoma

Endocyclophotocoagulation by pars plana approach in the management of refractory glaucoma with prior phacoemulsification and Ahmed gonioimplantation in a dog

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