Lisbon 2017 Delegate Registration Programme Exhibition Virtual Exhibition Satellites OneWorld Travel Discount
escrs app advert

Posters

Search Title by author or title

Endoscopic cyclophotocoagulation combined with phacoemulsification vs phacoemulsification alone in glaucoma management

Poster Details

First Author: A.Kennedy UK

Co Author(s):    H. Oliphant   L. Laneaster   P. Gouws              

Abstract Details

Purpose:

Glaucoma is an important cause of sight loss. In its chronic form, it is a progressive optic neuropathy with several risk factors including genetics, ethnicity and the modifiable intra-ocular pressure. In patients with visually signifcant cataract, phacoemulsification can be combined with endoscopic cyclophotocoagulation (phaco-ECP) to improve vision with the added benefit of improving (IOP) control. However, there is a lack of long term data comparing phaco-ECP with phacoemulsification alone (phaco-alone) in glaucoma. The aim of this study is to establish the effect of phaco-ECP versus phacoemulsifiacation alone on the management of glaucoma over a three-year follow-up period.

Setting:

Conquest Hospital, The Ridge, Hastings, Saint Leonards-on-sea TN37 7RD

Methods:

Design: retrospective single-centre interventional comparative study Population: all glaucoma patients undergoing phaco alone (253 eyes) or phaco-ECP (198 eyes) between 10/8/11 and 16/12/14 Main outcome measures: Number of agents, IOP and visual acuity (VA) at pre-op and 1, 2 and 3 years post-op. Other outcome measures: Drop-out rates, further glaucoma intervention rates, sub-group analysis ECP: -810nm diode laser via a fibre-optic cable using a Xenon light aiming beam -performed after IOL insertion -probe inserted via main port and side incision to cover 360�Â�°; inserted after inflation of ciliary sulcus with viscoelastic -laser used in �â�€�˜paint mode�â�€�™ to �â�€�˜paint�â�€�™ ciliary processes

Results:

Average number of agents pre-op was 2.1 in phaco-ECP and 1.7 in phaco-alone groups. It was 1 compared to no change after one year (p<0.0001, CI 0.53-0.98) and 1.4 compared to 1.8 after three years (p=0.0230, CI 0.05-0.65) respectively. Average IOP (mmHg) pre-op was 17.5 in phaco-ECP and 15.8 in phaco-alone groups. One year IOP was 13.6 and 14.2 (p=0.1122, CI -0.13-1.27) and three year was 13.1 and 14.7 (p=0.0005, CI 0.71-2.49) respectively. VA pre-op was 6/12 in phaco-ECP and 6/15 in phaco-alone groups. It was 6/7.5 in both groups at three years (p=0.2449, CI -0.178-0.046).

Conclusions:

In conclusion, there is a clear initial drop in the amounts of agents used and IOP in the study group compared to the control group. At the three-year time-point, the average number of agents is almost equal between the two groups but the IOP remains 2mmHg lower in the study group. Phaco-ECP is therefore an effective treatment option in patients with POAG and cataract for at least three years and further study is required to establish longer term effect.

Financial Disclosure:

NONE

Back to Poster listing