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03.01.2019 | Original Paper

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

Zeitschrift:
International Ophthalmology
Autor:
Vanita Pathak-Ray
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s10792-018-01062-9) contains supplementary material, which is available to authorized users.

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.

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Zusatzmaterial
ESM 1: Video that demonstrates technique of phaco-endocycloplasty and ECPL in pseudoexfoliation (MOV 48,142 kb)
ESM 2: Figure demonstrating quiet eye at 1-week post-phaco-ECPL with unscathed conjunctiva (TIFF 1069 kb)
10792_2018_1062_MOESM2_ESM.tiff
Literatur
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