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International Ophthalmology

, Volume 39, Issue 10, pp 2257–2265 | Cite as

Intermediate results of phaco-endocycloplasty in an exclusive cohort of angle closure glaucoma: potential for change

  • Vanita Pathak-RayEmail author
Original Paper
  • 82 Downloads

Abstract

Purpose

The objective of this study was to investigate the efficacy and safety of phaco-endocycloplasty in an exclusive cohort of primary angle closure disease/glaucoma.

Methods

The study was interventional and non-comparative, carried out at a tertiary level eye care Institute. All adult patients (> 18 years) with angle closure disease, who had controlled or uncontrolled intra-ocular pressure (IOP) and had visually significant cataract, requiring surgery, and had undergone phaco-endocycloplasty, performed for 180°–210° simultaneously with cataract surgery, were included.

Main outcome measures

Primary outcome measure includes IOP, and secondary outcome measures include best corrected logMAR visual acuity (BCVA), anti-glaucoma medication (AGM) and complications.

Results

Thirty-two eyes of 28 patients were included. Median follow-up was 15 months (range 3–42 months, Q1 7.5, Q3 18, IQR 10.5). Median IOP pre-procedure (20.5 mmHg, range 11–46, Q1 16.75, Q3 31, IQR 14.25) decreased significantly post-procedure at last follow-up (IOP 16 mmHg, range 10–20, Q1 12, Q3 17.5, IQR 5.5) (p < 0.001). There was significant decrease in use of AGM (median 3 pre-procedure, range 1–5, Q1 2, Q3 3.25, IQR 1.25) at last follow-up (median 0) (p < 0.001) post-procedure. Median logMAR BCVA improved from 0.4 (Q1 0.3, Q3 0.625, IQR 0.325) to 0.05 (Q1 0, Q3 0.3, IQR 0.3) at last follow-up (p < 0.001). None of the patients had serious sight-threatening complications.

Conclusions

This study indicates that phaco-endocycloplasty can effectively control IOP, significantly reducing need for AGM, without compromising safety, in angle closure glaucoma. When combined surgery is indicated, this conjunctiva-sparing procedure may be employed in the management of coexisting cataract and glaucoma prior to bleb-forming surgery.

Keywords

Endocycloplasty Phaco-endocycloplasty Primary angle closure glaucoma Endocyclophotocoagulation 

Notes

Acknowledgement

Author thanks IIK Ahmed, MD, University of Toronto, Department of Glaucoma, Credit Valley Eye Care, 3200 Erin Mills Parkway, Mississauga, Ontario, Canada L5L 1W8.

Funding

None.

Compliance with ethical standards

Conflict of interest

None relevant (Novartis, Allergan).

Supplementary material

ESM 1: Video that demonstrates technique of phaco-endocycloplasty and ECPL in pseudoexfoliation (MOV 48,142 kb)

10792_2018_1062_MOESM2_ESM.tiff (1 mb)
ESM 2: Figure demonstrating quiet eye at 1-week post-phaco-ECPL with unscathed conjunctiva (TIFF 1069 kb)

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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Centre for SightHyderabadIndia
  2. 2.L V Prasad Eye InstituteHyderabadIndia
  3. 3.Glaucoma FellowshipUniversity of TorontoTorontoCanada

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