Endoscopic cyclophotocoagulation for the treatment of glaucoma: an Asian experience

Abstract

Endoscopic cyclophotocoagulation may have a treatment role in Asian patients with glaucoma. The success rate appears poorer than previously reported in Caucasian populations. The treatment effect appeared to wane between 18 and 24 months post-treatment.

Intraocular Pressure Following Phacoemulsification and Endoscopic Cyclophotocoagulation for Advanced Glaucoma

“…In our study, there were no cases of hypotony, retinal detachment, and cystoid macular edema that have been previously reported. [2][3][4]7,14 Descemet's detachment in our study was secondary to an initial 1.8 mm incision for cataract surgery that occurred during insertion of the larger endoscopic probe. Hence, enlargement of the incision site is recommended for cataract surgery combined with ECP.…”

“…2 An Asian study of ECP reported that 2 of 6 failures were in pseudoexfoliation patients, but did not specify how many pseudoexfoliation patients were included in their sample. 4 They 4 hypothesized that the failure in both cases of PXG could be because of the attenuation of the laser energy due to the pseudoexfoliative material, resulting in suboptimal treatment.…”

“…Some have suggested an attenuation of the effects of combined procedures. 4 Lin et al 12 compared rabbit eyes that were treated with ECP or transscleral cyclophotocoagulation (TCP). They found that at 1 day postoperatively both groups had little to no blood flow in the treated areas; however, by 1 week, the ECP-treated eyes showed reperfusion that increased at 1 month postoperatively.…”

“…Vision reduction compared with preoperative levels in other studies has not been attributed to the Phaco/ECP procedure but to progression of glaucoma and/or concurrent disease, including cystoid macular edema, corneal decompensation, retinal detachment, trauma, and neovascular glaucoma. 2,[4][5][6][7]9 A study of patients with early glaucoma and no prior incisional surgery for glaucoma found no deterioration in best-corrected visual acuity 22 months after Phaco/ECP. 8 This observation suggests that the risk of postoperative vision loss is low in patients who have low or no comorbidities.…”

“…1 The safety and efficacy of ECP for lowering intraocular pressure (IOP) has been confirmed in several long-term studies. [2][3][4] ECP allows direct visualization and application of diode laser energy to the ciliary processes. Hence, it is less likely to produce the pain, inflammation, hypotony, and visual loss that can occur with transscleral cycloablation.…”