12-Month Outcomes After Phaco-Elios Procedure – A Real World Study

To describe the change in medication use and intraocular pressure in patients with glaucoma who have undergone a combined phacoemulsification-ELIOS procedure at 12 months.

Cataract surgery, although not considered a treatment for glaucoma due to its limited benefit in lowering IOP in open-angle glaucoma, can provide an opportunity to add procedures with this objective. The ELIOS system utilizes Excimer laser technology for ablating portions of the trabecular meshwork and inner wall of Schlemm´s canal to create ten trabeculostomy openings that remove part of the major resistance to outflow and thus lowering medication burden and/or intraocular pressure (IOP).

Retrospective, multicenter chart review of adult patients diagnosed with ocular hypertension or glaucoma who were underwent cataract surgery at 2 centers in Spain. Preoperative and postoperative clinical data was collected and analyzed up to 12 months. The main outcome measure was the mean change in medication as compared to baseline. Intraocular pressure was analyzed as a secondary outcome. Surgical approach consisted of routine cataract surgery combined with a 308 nm excimer laser delivered through an intraocular fiberoptic probe to create 10 microchannels through the trabecular meshwork  up to the inner wall of Schlemm´s canal with postoperative management and follow-up comparable to routine standalone phacoemulsification.

112 eyes were included. Sixty (53.6%) females and 52 (46.4%) males with mean age of 70.5 years. Sample included OHT (8.9%), primary open angle glaucoma (71.4%), chronic angle closure glaucoma (8.0%) and other types of glaucoma (11.6%). Mean IOP at baseline was 19.8 mmHg. Mean number of medications at baseline was 1.8 and 0.36 at 12 months, representing a reduction of -1.46. 93 patients (83%) showed reduction in number of medications with respect to baseline, 81 of them (72%) were medication free at 12 months. 56% of patients had a combined result of medication reduction down to zero and IOP decrease with respect to baseline . At 12 months mean IOP was 16.6 mmHg representing a mean percentage of reduction of 14% respect to baseline 

Combining phacoemulsification with ELIOS in adult patients with OHT or glaucoma showed a significant reduction in medication use with almost three quarters of the patients being medication free at 12 months, and with over 50% of these having an IOP drop with respect to baseline.