Initial outcomes of combined phacoemulsification with endocyclophotocoagulation with and without ab interno trabeculotomy in open-angle glaucoma

Session Details

Session Title: Microinvasive Glaucoma Surgery

Session Date/Time: Sunday 15/09/2019 | 14:00-16:00

Paper Time: 15:06

Venue: Free Paper Forum: Podium 4

First Author: : J.Izquierdo PERU

Co Author(s): :    N. Agudelo   B. Rubio   C. Ponte   J. Camargo   L. Cañola                 

Abstract Details

Purpose:

To evaluate the efficacy and safety of combined phacoemulsification with endocyclophotocoagulation with and without ab interno trabeculotomy in patients with uncontrolled open angle glaucoma.

Setting:

Glaucoma and Cataract are two coexisting diseases in elderly patients that cause irreversible and reversible blindness respectively. The gold standard filtering surgery had high rate of complications. Alternative treatments need to be evaluated with better safety.

Methods:

Comparative retrospective study evaluated the 12 months outcomes of patients with uncontrolled open angle glaucoma who underwent combined phacoemulsification with endocyclophotocoagulation and ab interno trabeculotomy (group I) vs phacoemulsification with endocyclophotocoagulation (group II). The primary outcome measure was mean preoperative and postoperative intraocular pressure (IOP); secondary outcomes included: number of glaucoma medications, visual acuity, report complete and qualified success, failure, and complications.

Results:

A total of 46 eyes were included, preoperative IOP was 16.96 ± 3.66 mmHg for group I and 15.64± 4.88 mmHg for group II (p=0.122), 11.44 ± 2.15 mmHg and 12.45 ± 1.90 mmHg respectively (p= 0.031) at 12 months. Complete success: 54.5% for group I and 40.7% for group II; qualified success was 92.6% (p = 0.011) and 90.9% (p= 0.011) respectively. Medications fell from 2.0 ± 1.4 to 0.8 ± 1.0 (p:0.001) in group I and 1.5 ± 1.3 to 1.0 ± 1.5 in group II (p=0.032). Visual acuity improved similar. Complications were mild and resolve without re-interventions.

Conclusions:

Patients with uncontrolled open angle glaucoma at 12 months follow up shows reduction of IOP efficiently and safety with both procedures. When ab interno trabeculotomy is added to phacoemulsification and ECP mean IOP is reduced more and this difference comparing both interventions studied is clinically significant.

Financial Disclosure:

None