Endoscopic cyclophotocoagulation (ECP) for open angle glaucoma and primary angle closure

Tóth, Márta; Shah, Anupa; Hu, Kuang; Bunce, Catey; Gazzard, Gus

doi:10.1002/14651858.cd012741.pub2

Cited by 26 publications

(17 citation statements)

References 29 publications

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“…We included trials in which CPC was performed alone or in combination with another procedure. We excluded trials in which endoscopic cyclophotocoagulation was compared with non-cyclodestructive glaucoma treatments, as these trials are covered in another Cochrane Review (Tóth 2017). …”

Section: Methodsmentioning

confidence: 99%

Cyclodestructive procedures for non-refractory glaucoma

Chen

Kim

Coleman

2018

Cochrane Database of Systematic Reviews

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Background Glaucoma is a leading cause of blindness worldwide. It results in a progressive loss of peripheral vision and, in late stages, loss of central vision leading to blindness. Early treatment of glaucoma aims to prevent or delay vision loss. Elevated intraocular pressure (IOP) is the main causal modifiable risk factor for glaucoma. Aqueous outflow obstruction is the main cause of IOP elevation, which can be mitigated either by increasing outflow or reducing aqueous humor production. Cyclodestructive procedures use various methods to target and destroy the ciliary body epithelium, the site of aqueous humor production, thereby lowering IOP. The most common approach is laser cyclophotocoagulation. Objectives To assess the effectiveness and safety of cyclodestructive procedures for the management of non-refractory glaucoma (i.e. glaucoma in an eye that has not undergone incisional glaucoma surgery). We also aimed to compare the effect of different routes of administration, laser delivery instruments, and parameters of cyclophotocoagulation with respect to IOP control, visual acuity, pain control, and adverse events. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2017, Issue 8); Ovid MEDLINE; Embase.com; LILACS; the metaRegister of Controlled Trials (mRCT) and ClinicalTrials.gov . The date of the search was 7 August 2017. We also searched the reference lists of reports from included studies. Selection criteria We included randomized controlled trials of participants who had undergone cyclodestruction as a primary treatment for glaucoma. We included only head-to-head trials that had compared cyclophotocoagulation to other procedural interventions, or compared cyclophotocoagulation using different types of lasers, delivery methods, parameters, or a combination of these factors. Data collection and analysis Two review authors independently screened search results, assessed risks of bias, extracted data, and graded the certainty of the evidence in accordance with Cochrane standards. Main results We included one trial (92 eyes of 92 participants) that evaluated the efficacy of diode transscleral cyclophotocoagulation (TSCPC) as primary surgical therapy. We identified no other eligible ongoing or completed trial. The included trial compared low-energy versus high-energy TSCPC in eyes with primary open-angle glaucoma. The trial was conducted in Ghana and had a mean follow-up period of 13.2 months post-treatment. In this trial, low-energy TSCPC was defined as 45.0 J delivered, high-energy as 65.5 J delivered; it is worth noting that other trials have defined high- and low-energy TSCPC differently. We assessed this trial to have had low risk of selection bias and reporting bias, unclear risk of performance bias, and high risk of detection bias and attrition bias. Trial authors excluded 13 participants with missing follow-up data; the analyses therefore included 40 (85%) of 47 participants in the low-energy ...

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Section: Methodsmentioning

confidence: 99%

Cyclodestructive procedures for non-refractory glaucoma

Chen

Kim

Coleman

2018

Cochrane Database of Systematic Reviews

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“…640 Another 2019 Cochrane Systematic Review identified no studies on the effects of endocyclophotocoagulation for open-angle glaucoma. 641 Additional randomized clinical trials are needed to further elucidate the merits of each type of cyclophotocoagulation relative to one another as well as to other types of glaucoma surgery. 640,641 Therefore, the selection of cyclophotocoagulation over other procedures should be left to the discretion of the treating ophthalmologist, in consultation with the individual patient.…”

Section: P112mentioning

confidence: 99%

Primary Open-Angle Glaucoma Preferred Practice Pattern®

Gedde¹,

et al. 2021

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“…There is, however, limited knowledge of the safety profile of ECP due to the lack of high-level evidence in the form of randomised controlled trials. One study, currently in the data collection phase, is investigating patients with POAG receiving either ECP with phacoemulsification or phacoemulsification as a standalone procedure [28] .…”

Section: Migs Targeting the Ciliary Processmentioning

confidence: 99%

Minimally invasive glaucoma surgery - current and emerging techniques to reduce intraocular pressure and medications

Komzak¹,

Rothschild²,

Hooshmand³

et al. 2021

Mini-invasive Surg

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Minimally invasive glaucoma surgery (MIGS) has become increasingly popular as a step in the management pathway of open angle glaucoma. Due to the relative novelty of these devices, there remains some paucity of evidence relating to their long-term efficacy and safety, and this can make comparison between these techniques somewhat complex. This review article aims to guide clinical decision making by providing the latest evidence on the comparative efficacy of current iterations of minimally invasive glaucoma surgery. A literature review was conducted to identify the most significant recent evidence to support the safety and efficacy of the various forms of minimally invasive glaucoma surgery. Included studies provided efficacy and safety data on a variety of minimally invasive glaucoma surgery methods. The PubMed database was searched and a total of 484 studies, published between 2015 and 2020 were identified, of which 27 were included. The studies indicate that most available forms of minimally invasive glaucoma surgery show statistically significant efficacy in terms of intraocular pressure reduction and improvement in medication burden, while maintaining an acceptable safety profile.

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Endoscopic cyclophotocoagulation (ECP) for open angle glaucoma and primary angle closure

Abstract: Endoscopic cyclophotocoagulation (ECP) for open angle glaucoma and primary angle closure.

Cited by 26 publications

References 29 publications

Cyclodestructive procedures for non-refractory glaucoma

Cyclodestructive procedures for non-refractory glaucoma

Primary Open-Angle Glaucoma Preferred Practice Pattern®

Minimally invasive glaucoma surgery - current and emerging techniques to reduce intraocular pressure and medications

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