Real World Outcomes Of Phaco-Elios – Results At 12 And 24 Months

To describe the change in medication use and intraocular pressure (IOP) in patients with glaucoma who have undergone a combined phacoemulsification-ELIOS procedure at 12 and 24 months.

Minimally invasive glaucoma surgery (MIGS) offers a more modest IOP-lowering effect than traditional filtering surgery but has a better safety profile, positioning well in mild-to-moderate glaucoma with modest treatment goals. Excimer Laser IntraOcular Surgery (ELIOS) performs laser trabeculostomies to decrease outflow resistance and thus IOP. This interaction is photoablative and non-thermal producing scant damage to the surrounding tissue, minimum inflammation and less scar tissue formation.

Retrospective, single-center chart review of patients with ocular hypertension or glaucoma who underwent phaco-ELIOS surgery in Spain. Data was collected and analyzed up to 24 months (POM24). Main outcome measure was mean change in medication compared to baseline (BL). IOP was analyzed as a secondary outcome. Phacoemulsification combined with ELIOS was made, which entails entering the viscoelastic-filled anterior chamber through a clear-corneal incision with a  intraocular laser probe to contact the trabecular meshwork and with gonioscopy create 10 microchannels over the nasal quadrant. Surgery  concludes as per routine phacoemulsification. Post-operative medications and follow-up visits are identical to routine phacoemulsification.

126 eyes were included. Most eyes had primary open angle glaucoma. Mean IOP at BL was 20.7 mmHg with a mean number of medications of 1.63. Mean number of medications at POM12 and POM24 was 0.31 and 0.45, respectively, a change from BL of -1.31 and -1.17, respectively. At POM12, 90% of eyes reduced number of medications, 76.8% of these were medication-free. At 24 months, 69.6% of eyes showed reduction of medications, 59.8% of them were medication-free. 59.5% and 48% of eyes had a combined result of medication reduction down to zero and IOP decrease with respect to BL at POM12 and POM24, respectively. Mean IOP was 17.2 and 17.7 mmHg, representing a mean reduction as compared to BL of 15.7% and 12.8% at POM12 and POM24, respectively.

Above 75% of eyes at 12 months and almost 60% of eyes at 24 months were medication-free. IOP was analyzed as a secondary outcome, showing a 15.7% and 12.8% reduction from baseline at 12 and 24 months, respectively. Combining phacoemulsification with ELIOS in adult patients with OHT or glaucoma showed a significant reduction in medication use sustained at all timepoints of the 24-month follow-up period, as well as reduction in IOP.