[Phacoemulsification and endoscopic cyclophotocoagulation as primary surgical procedure in coexisting cataract and glaucoma]

Arq Bras Oftalmol. Sep-Oct 2010;73(5):419-22. doi: 10.1590/s0004-27492010000500006.
[Article in Portuguese]

Abstract

Purpose: To evaluate the safety and efficacy of phacoemulsification and endoscopic cyclophotocoagulation (ECP) as a primary surgical treatment for glaucoma and cataract.

Methods: Three hundred and sixty-eight eyes from 243 patients with primary open-angle glaucoma and cataract from the Centro Brasileiro de Cirurgia de Olhos that underwent an uncomplicated surgery from October, 1998 to December, 2006 with at least 2 years of follow-up were retrospectively enrolled. The patients were excluded if presented a previous ocular history of any intraocular surgery or glaucoma laser treatment. Qualified success was defined as 5 mmHg < intraocular pressure (IOP) < 21 mmHg with or without topical antiglaucomatous drugs, and complete success as the same IOP levels without therapy at all timepoints. Additionally, the requirement of any further glaucoma surgery was defined as failure.

Results: The mean follow-up was 35.15 + 8.14 months. The preoperative IOP (23.07 + 5.52 mmHg) was significantly greater than in the first postoperative day (13.14 + 6.09 mmHg), and months 1 (11.03 + 2.59 mmHg), 6 (12.33 + 3.01 mmHg), 12 (12.19 + 2.19 mmHg), 24 (12.14 + 2.89 mmHg) and in the last appointment (12.29 + 2.44 mmHg) (p<0.001 in all timepoints). The number of preoperative medications (1.44 + 0.97) decreased (0.37 + 0.74) (p<0.001). Furthermore, there was a significant improvement in the logMAR visual acuity (p=0.01). Three hundred and thirty-four eyes (90.76%) achieved qualified success, and 205 (55.7%) complete success. Complications included immediate postoperative IOP spike 14.4% (53/368), postoperative fibrin exudates in anterior chamber 7.06% (26/368), cystoid macular edema 4.34% (16/368), transitory hypotony 2.17% (8/368), iris bombé 1.08% (4/368).

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

Publication types

  • English Abstract

MeSH terms

  • Aged
  • Cataract / complications
  • Cataract / therapy*
  • Endoscopy / adverse effects*
  • Female
  • Follow-Up Studies
  • Glaucoma / complications
  • Glaucoma / surgery*
  • Humans
  • Intraocular Pressure / physiology
  • Laser Coagulation / adverse effects*
  • Male
  • Phacoemulsification / adverse effects*
  • Postoperative Period
  • Preoperative Period
  • Treatment Outcome