Middle East African Journal of Ophthalmology

ORIGINAL ARTICLE
Year
: 2017  |  Volume : 24  |  Issue : 4  |  Page : 177--182

Cataract and glaucoma surgery: Endoscopic cyclophotocoagulation versus trabeculectomy


Sheila Marco1, Karim F Damji2, Samir Nazarali3, Chris J Rudnisky2 
1 Department of Ophthalmology, University of Nairobi, Nairobi, Kenya
2 Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Canada
3 Faculty of Medicine, University of Ottawa, Ottawa, Canada

Correspondence Address:
Sheila Marco
P.O. Box 19785-00100, Nairobi
Kenya

PURPOSE: To compare the efficacy and safety of endoscopic cyclophotocoagulation (ECP) versus trabeculectomy with mitomycin C (trab) in combination with cataract surgery. MATERIALS AND METHODS: We evaluated the 6-month results of patients undergoing phacoemulsification (phaco) with either ECP or trab. The primary outcome was mean intraocular pressure (IOP) at 6 months; secondary outcomes were change in glaucoma medications, visual acuity, intraocular inflammation, and postoperative complications. Complete success was a target IOP of <21 mmHg and >6 mmHg without glaucoma medications. Qualified success was target IOP achieved through glaucoma medications. RESULTS: We evaluated 53 eyes of 53 patients; 24 (45.3%) eyes were treated with ECP-phaco and 29 (54.7%) with trab-phaco. At 6 months, there was no significant difference in mean IOP of the two groups (ECP-phaco 14.2 ± 3.6 mmHg; trab-phaco 13.0 ± 2.5 mmHg; P = 0.240). Six (25.0%) ECP-phaco eyes and 20 (69.0%) trab-phaco eyes achieved complete success (P = 0.002). Qualified success was achieved in 18 (75.0%) ECP-phaco eyes and 9 (31.0%) trab-phaco eyes (P = 0.002). The mean reduction of medication from baseline was significant (ECP-phaco 1.2 ± 1.1; trab-phaco 2.1 ± 1.5; P = 0.020). ECP-phaco resulted in more IOP spikes on the 1st postoperative day (P = 0.040) and more anterior cellular reaction at 1 week and 1 month compared to trab-phaco (P < 0.05). The rate of postoperative complications was not significantly different between groups. CONCLUSION: At 6 months, ECP-phaco demonstrated similar improvements in IOP and visual acuity compared to trab-phaco. However, ECP-phaco patients had higher incidences of immediate postoperative IOP spikes and anterior chamber inflammation as well as requiring additional medications postoperatively.


How to cite this article:
Marco S, Damji KF, Nazarali S, Rudnisky CJ. Cataract and glaucoma surgery: Endoscopic cyclophotocoagulation versus trabeculectomy.Middle East Afr J Ophthalmol 2017;24:177-182


How to cite this URL:
Marco S, Damji KF, Nazarali S, Rudnisky CJ. Cataract and glaucoma surgery: Endoscopic cyclophotocoagulation versus trabeculectomy. Middle East Afr J Ophthalmol [serial online] 2017 [cited 2020 Aug 13 ];24:177-182
Available from: http://www.meajo.org/article.asp?issn=0974-9233;year=2017;volume=24;issue=4;spage=177;epage=182;aulast=Marco;type=0