Facoemulsificação e ciclofotocoagulação endoscópica como tratamento primário para catarata e glaucoma coexistentes

Lima, Francisco José de; Carvalho, Durval Moraes de; Ávila, Marcos Pereira de

doi:10.1590/s0004-27492010000500006

Cited by 45 publications

(33 citation statements)

References 14 publications

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“…To try to give some type of comparison from the available data, a single iStent has been shown to reduce the IOP by 8%43–27%47 with an overall mean final IOP near 17 mm Hg with significantly greater reductions reported when inserting more than one stent 46. Endoscopic cyclophotocoagulation used for POAG (as opposed to neovascular glaucoma) decreases the IOP by 8%48–47%,49 to a final average near 15 mm Hg. In the TVT Study, the Baerveldt glaucoma drainage device lowered the IOP by 41% (mean IOP at 5 years was 14.4 mm Hg) and trabeculectomy by 50% (mean IOP at 5 years was 12.6 mm Hg) 24…”

Section: Resultsmentioning

confidence: 99%

Review and meta-analysis of ab-interno trabeculectomy outcomes

et al. 2016

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We analysed all of the PubMed publications on ab-interno trabeculectomy (AIT) with the Trabectome (Neomedix, Irvine, California, USA) to determine the reduction in intraocular pressure (IOP) and medications following the procedure. For IOP outcomes, PubMed was searched for 'trabectome', 'ab interno trabeculotomy' and 'ab interno trabeculectomy' and all available papers retrieved. The meta-analysis used a random-effects model to achieve conservative estimates and assess statistical heterogeneity. To investigate complications, we included all abstracts from the American Glaucoma Society, American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery and the Association for Research in Vision and Ophthalmology. The overall arithmetic mean baseline IOP for standalone Trabectome was 26.71±1.34 mm Hg and decreased by 10.5±1.9 mm Hg (39% decrease) on 0.99±0.54 fewer medications. Defining success as IOP ≤21 with a 20% decrease while avoiding reoperation, the overall average success rate after 2 years was 46±34%. For combined phacoemulsification-Trabectome, the baseline IOP of 21±1.31 mm Hg decreased by 6.24±1.98 mm Hg (27% decrease) on 0.76±0.35 fewer medications. The success rate using the same definition at 2 years was 85±7%. The weighted mean IOP difference from baseline to study endpoint was 9.77 mm Hg (95% CI 8.90 to 10.64) standalone and 6.04 mm Hg (95% CI 4.95 to 7.13) for combined cases. Despite heterogeneity, meta-analysis showed significant and consistent decrease in IOP and medications from baseline to end point in AIT and phaco-AIT. The rate of visually threatening complications was <1%. On average, trabectome lowers the IOP by approximately 31% to a final IOP near 15 mm Hg while decreasing the number of medications by less than one, with a low rate of serious complications. After 2 years, the overall average success rate is 66%.

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Section: Resultsmentioning

confidence: 99%

Review and meta-analysis of ab-interno trabeculectomy outcomes

et al. 2016

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“…It could be performed combined with alternative surgeries, such as phacoemulsification and vitrectomy, etc. 14 Lima et al 15 recommended ECP as the primary therapy of glaucoma, and ECP combined with phacoemulsification for coexisting cataract and glaucoma.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Efficacy Between Endoscopic Cyclophotocoagulation and Alternative Surgeries in Refractory Glaucoma

et al. 2015

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Refractory glaucoma refers to uncontrolled intraocular pressure (IOP) despite anti-glaucoma medication and surgical treatment, which remains a challenge to be treated. The objective of this study is to evaluate and statistically compare the clinical efficacy between endoscopic cyclophotocoagulation (ECP) and alternative surgical techniques in the treatment of refractory glaucoma in this article, as a meta-analysis.Data sources are China Biomedical Database (Sinomed, online version), China National Knowledge Infrastructure (CNKI), Cqvip, Wanfang database, and PubMed.The randomized controlled trial (RCT) and case–control study literatures evaluating the clinical efficacy between ECP and other surgical techniques were searched electronically from public databases. The methodology quality of the retrieved articles was evaluated according to the RCT or case–control study criteria. The success rate of treatment, intraocular pressure (IOP) and visual acuity were statistically compared. RevMan 5.3 software was used for the meta-analysis.In total, 6 relevant control studies were selected in this study with a total sampling of 429 cases (429 eyes), including 204 eyes in the ECP group and 225 in the non-ECP group. Meta-analysis demonstrated that the clinical efficacy did not significantly differ between 2 groups (P > 0.05). Postoperative IOP was dramatically reduced in both groups. However, it was difficult to evaluate the combined influence of ECP and non-ECP therapies upon IOP reduction.In conclusion, ECP and non-ECP treatment yielded almost equivalent clinical efficacy in treating refractory glaucoma. The IOP-lowering degree, safety, and incidence of complications remain to be further elucidated by RCTs with a larger sample size.

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“…Partial response was achieved in 334 eyes (90.76%) and complete response was achieved in 205 eyes (55.7%). The following postoperative complications were observed: IOP spikes [14.4% (53/368)], anterior chamber fibrin [7.06% (26/368)], cystoid macular edema [4.34% (16/368)], ocular hypotony [2.17% (8/368)], and iris bombe [1.08% (4/368)] [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Endocyclophotodestruction in Glaucoma Patients Undergoing Combined Surgery of Pars Plana Vitrectomy and Phacoemulsification

2014

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BackgroundThe purpose of this trail was to assess the effect of a novel intraoperative endocyclophotodestruction method on intraocular pressure in patients undergoing combined procedure of phacovitrectomy to determine the efficacy of this combined surgical approach.Material/MethodsThe study sample included 87 subjects divided into 2 groups: Group I consisted of 52 patients who underwent intraoperative endocyclophotodestruction performed during phacovitrectomy. Group II consisted of 35 controls. The follow-up duration was 12 months. The preoperative (baseline) intraocular pressure (IOP) was determined and later assessed postoperatively at the following time points: on 1 day and at 1, 2, 3, 6, and 12 months. Other evaluated parameters were the number of topical antiglaucoma medications, and the cyclophotodestruction circumference-to-outflow resistance ratio (R).ResultsThe mean postoperative reduction of intraocular pressure was by 4.26 mmHg at 6 months and by 4.91 mmHg at 12 months. The number of topical antiglaucoma medications was reduced postoperatively from the mean preoperative value of 1.66 to 0.69 at 6 months and 1.04 at 12 months.ConclusionsThe results show a significant reduction of intraocular pressure in patients undergoing the combined triple-procedure surgery and postoperative decrease in the number of topical medications. The best outcomes in terms of IOP decrease and reduced number of medications were achieved in patients with low outflow coefficient. Endocyclophotodestruction is an alternative IOP-reducing technique to be used in patients with glaucoma who require phacovitrectomy. It is recommended for patients with low outflow coefficient in whom posterior pole abnormalities constitute the main indications for surgery.

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Facoemulsificação e ciclofotocoagulação endoscópica como tratamento primário para catarata e glaucoma coexistentes

Abstract: Phacoemulsification associated with endoscopic cyclophotocoagulation is safe and effective as a primary procedure for combined glaucoma and cataract.

Cited by 45 publications

References 14 publications

Review and meta-analysis of ab-interno trabeculectomy outcomes

Review and meta-analysis of ab-interno trabeculectomy outcomes

Comparison of Efficacy Between Endoscopic Cyclophotocoagulation and Alternative Surgeries in Refractory Glaucoma

Endocyclophotodestruction in Glaucoma Patients Undergoing Combined Surgery of Pars Plana Vitrectomy and Phacoemulsification

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