Comparative Study: Phaco With Micro-Pulse Cyclophotocoagulation Vs Phaco With Endoscopic Cyclophotocoagulation
Published 2026 - 44th Congress of the ESCRS
Reference: POGAU002 | Type: Free paper | DOI: 10.82333/r4b1-y147
Authors: Dr Saad mutlaq Alosaimi* 1 , Dr Medhat Bakr 2 , Dr Ahmed Alzhrani 3 , Dr Khalid Alenzi 4
1Ophthalmology ,MOH,Riyadh,Saudi Arabia, 2Ophthalmology ,IAU,Khober,Saudi Arabia, 3Ophthalmology ,IAU,Khober,Saudi Arabia;Ophthalmology ,Moh,Khober,Saudi Arabia, 4Ophthalmology ,Iau,Khober,Saudi Arabia
Purpose
Background: Glaucoma is a leading cause of irreversible blindness globally, primarily managed by lowering intraocular pressure (IOP). Phacoemulsification alone provides modest IOP reduction in patients with coexisting cataract and glaucoma. To enhance IOP control, combining cataract surgery with cyclophotocoagulation has emerged as a promising strategy.
Setting
Two such techniques—micro-pulse transscleral cyclophotocoagulation (MP-TCP) and endoscopic cyclophotocoagulation (ECP)—offer different mechanisms of ciliary body ablation with varying degrees of invasiveness and efficacy. The current study aimed to compare the efficacy and safety of phacoemulsification combined with MP-TCP versus phacoemulsification combined with ECP in patients with coexisting cataract and glaucoma.
Methods
Methods: In this prospective randomized controlled trial, adults aged 40–80 years undergoing cataract surgery with glaucoma were enrolled and randomized to receive either Phaco+MP-TCP or Phaco+ECP. Primary outcomes included changes in IOP, number of IOP-lowering medications, visual acuity (logMAR), and postoperative complications over a 12-month follow-up.
Results
Results: A total of 39 patients were randomized (24 ECP, 15 MP-TCP). Baseline characteristics were comparable. Both groups showed significant IOP reduction over time (p<0.0001). ECP produced greater early IOP reduction (1 week: p=0.015; 3 months: p=0.001), while MP-TCP showed a more significant and sustained reduction in medication burden (p<0.0001). Visual acuity improved significantly in both groups with no significant difference. Complication rates were low and comparable between groups.
Conclusions
Conclusion: Both Phaco+MP-TCP and Phaco+ECP are effective, safe surgical options for managing glaucoma in patients undergoing cataract surgery. ECP offers superior early IOP reduction, whereas MP-TCP more effectively reduces medication dependence. The choice of technique should be tailored to individual clinical priorities.