Refractive outcome of combined phacoemulsification and endoscopic cyclophotocoagulation

Kang, Seok; Luk, Sheila; Han, Haegin; Cordeiro, M. Francesca; Ahmed, Faisal; Bloom, Philip; Crawley, Laura

doi:10.1007/s10792-016-0411-4

Cited by 13 publications

(22 citation statements)

References 11 publications

(12 reference statements)

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“…Keratometry measurements also play a significant role in IOL calculations [15]. Because MIGS surgeries use the pre-existing clear corneal wound used for phacoemulsification, they should not add any induced astigmatism beyond what is already induced by the cataract extraction itself.…”

Section: Discussionmentioning

confidence: 99%

“…The effect on post-operative refraction has previously been evaluated in other MIGS procedures with mixed results. Kang et al found no change in refractive outcome between phacoemulsification alone compared to phacoemulsification plus ECP [15]. Conversely, Sheybani et al demonstrated that ECP performed in addition to phacoemulsification led to an increase in the rate of myopic surprise compared to cataract surgery alone [16].…”

Section: Discussionmentioning

confidence: 99%

“…Manoharan et al demonstrated there was no difference in refractive outcomes in glaucoma patients who underwent combined phacoemulsification with iStent compared to phacoemulsification alone [8]. Moreover, there have been conflicting results on the impact of endocyclophotocoagulation (ECP) at the time of phacoemulsification and its influences on refractive outcomes [15–17].…”

Section: Introductionmentioning

confidence: 99%

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Refractive outcomes among glaucoma patients undergoing phacoemulsification cataract extraction with and without Kahook Dual Blade goniotomy

et al. 2019

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Background Glaucoma patients undergoing phacoemulsification alone have a higher rate of refractive surprise compared to patients without glaucoma. This risk is further increased with combined filtering procedures. Indeed, there are few and conflicting reports on the effect of combined phacoemulsification and micro-invasive glaucoma surgery (MIGS). Here, we look at refractive outcomes of glaucoma patients undergoing phacoemulsification with and without Kahook Dual Blade (KDB) goniotomy. Methods Retrospective chart review of 385 glaucomatous eyes of 281 patients, which underwent either phacoemulsification alone (n = 309) or phacoemulsification with KDB goniotomy (n = 76, phaco-KDB) at the University of Colorado. The main outcome was refractive surprise defined as the difference in target and postoperative refraction spherical equivalent greater than ±0.5 Diopter (D). Results Refractive surprise greater than ±0.5 D occurred in 26.3% of eyes in the phaco-KDB group and 36.2% in the phacoemulsification group (p = 0.11). Refractive surprise greater than ±1.0 D occurred in 6.6% for the phaco-KDB group and 9.7% for the phacoemulsification group (p = 0.08). There was no significant difference in risk of refractive surprise when pre-operative IOP, axial length, keratometry or performance of KDB goniotomy were assessed in univariate analyses. Conclusion There was no difference between refractive outcomes of glaucomatous patients undergoing phacoemulsification with or without KDB goniotomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Refractive outcomes among glaucoma patients undergoing phacoemulsification cataract extraction with and without Kahook Dual Blade goniotomy

et al. 2019

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“…GSL and ECP aim to provide a safer, less invasive means of lowering IOP than traditional filtering surgeries and are associated with significantly fewer complications. [5789101118] In patients with mild-to-moderate glaucoma and surgically naive eyes, Siegel et al demonstrated the following postoperative complication rates of phaco/ECP in 261 eyes: CME in 1.5%, retinal detachment in 0.7%, and transient IOP elevations in 8%, without any cases of hyphema, persistent inflammation, or hypotony. [19] The patients in our study did not experience any surgical complications.…”

Section: Discussionmentioning

confidence: 99%

“…The technique of combining phacoemulsification with ECP (phaco/ECP) has emerged as a viable option to simultaneously treat both cataract and glaucoma. [710]…”

mentioning

confidence: 99%

Surgical outcomes of phacoemulsification/goniosynechialysis with and without endocyclophotocoagulation in patients with chronic angle closure glaucoma

Panse

Hubbell

et al. 2019

Indian J Ophthalmol

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Purpose: To compare surgical outcomes of patients after phacoemulsification with goniosynechialysis (phaco/GSL) versus phaco with GSL and endocyclophotocoagulation (phaco/GSL/ECP) in patients with chronic angle closure glaucoma (CACG) through 12-month follow-up. Methods: A retrospective, nonrandomized, comparative case series was performed. Patients with CACG who underwent phaco in combination with either GSL alone (group 1) or GSL with ECP with intracameral injection of kenalog (group 2) from 2011 to 2018 were included. Group 1 included 6 eyes of 6 patients and group 2 included 11 eyes of 10 patients. All surgeries were performed by a single surgeon (RSA). Primary outcome measures included changes in intraocular pressure (IOP), visual acuity (VA), failure based on IOP (>18 or <6 mmHg at 1 year), and secondary operative procedures and complication rates. Data were analyzed using a paired two-tailed T -test. Results: The mean preoperative IOP decreased from 23.5 ± 11.2 to 14.2 ± 2.4 mmHg ( P < 0.0073) in group 1 and 24.4 ± 8.2 to 14.5 ± 2.7 mmHg ( P < 0.0001) in group 2. The mean % IOP reduction was 33.7% in group 1 and 34.2% in group 2. The mean improvement in VA (logMAR units) was 0.24 ( P = 0.085) in group 1 and 0.13 ( P = 0.657) in group 2. The mean number of topical meds decreased from 2.50 ± 1.76 to 1.80 ± 1.64 in group 1 ( P = 0.513) and from 2.82 ± 1.25 to 1.17 ± 0.98 in group 2 ( P = 0.014). Conclusion: Phaco/GSL and phaco/GSL/ECP both achieve a significant reduction in IOP without the complications associated with traditional glaucoma filtration surgeries.

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Does prior endoscopic cyclophotocoagulation (ECP) affect subsequent trabeculectomy outcomes?

Mohite

Samia-Aly

Ramanathan

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Purpose To report long-term outcomes of trabeculectomy following prior endoscopic cyclophotocoagulation (ECP). Methods Retrospective case-controlled comparative study reporting 2-year outcomes of eyes undergoing trabeculectomy following failed prior ECP (group 1), using eyes undergoing trabeculectomy as a primary glaucoma procedure as controls (group 2). Results Filtration surgery was required in only 19.4% (12/62) of eyes undergoing ECP. Of these, nine eyes that underwent trabeculectomies were included in group 1. Nine matched eyes were used as controls and included in group 2. Mean baseline IOPs were 23.7 ± 7.7 and 26.0 ± 6.7 mmHg ( p = 0.452) in groups 1 and 2, respectively, on a mean of 3.4 ± 0.9 and 2.8 ± 1.4 medications, respectively ( p = 0.274). The mean 2-year IOP was 10.6 ± 5.2 and 12.9 ± 4.0 mmHg ( p = 0.285) in groups 1 and 2, respectively, on a mean of 0.1 ± 0.3 and 0.1 ± 0.4 medications ( p = 0.931) respectively. Complete success rates were 77.8% and 88.9% in groups 1 and 2, respectively ( p = 0.527). Qualified success rates were 11.1% in both groups. Combined success rates were 88.9% and 100.0% in groups 1 and 2, respectively ( p = 0.318). There were no failures in group 2, compared to 11.1% in group 1 ( p = 0.318). There were no significant between-group differences in hypotony, bleb needling, cystoid macular oedema, persistent uveitis, or repeat filtration surgery rates. Conclusions ECP is a safe initial procedure in eyes with progressive glaucomas, and may substantially reduce the need for trabeculectomy without compromising outcomes in the minority that go on to require it.

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Refractive outcome of combined phacoemulsification and endoscopic cyclophotocoagulation

Cited by 13 publications

References 11 publications

Refractive outcomes among glaucoma patients undergoing phacoemulsification cataract extraction with and without Kahook Dual Blade goniotomy

Refractive outcomes among glaucoma patients undergoing phacoemulsification cataract extraction with and without Kahook Dual Blade goniotomy

Surgical outcomes of phacoemulsification/goniosynechialysis with and without endocyclophotocoagulation in patients with chronic angle closure glaucoma

Does prior endoscopic cyclophotocoagulation (ECP) affect subsequent trabeculectomy outcomes?

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