Vanita Pathak-Ray1,2,3. 1. Centre for Sight, Road No 2 Banjara Hills, Hyderabad, 500034, India. vpathakray@gmail.com. 2. L V Prasad Eye Institute, Road No 2 Banjara Hills, Hyderabad, 500034, India. vpathakray@gmail.com. 3. Glaucoma Fellowship, University of Toronto, Toronto, ON, Canada. vpathakray@gmail.com.
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.
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.
Authors: Monisha E Nongpiur; Mingguang He; Nishani Amerasinghe; David S Friedman; Wan-Ting Tay; Mani Baskaran; Scott D Smith; Tien Yin Wong; Tin Aung Journal: Ophthalmology Date: 2010-10-29 Impact factor: 12.079
Authors: Marcus C C Lim; Laurence S Lim; Gus Gazzard; Rahat Husain; Yiong-Huak Chan; Steve K L Seah; Tin Aung Journal: J Glaucoma Date: 2006-06 Impact factor: 2.503