Lowing-IOP effect of endoscopic cyclophotocoagulation combined with phacoemulsification and IOL in rabbit chronic glaucomatous eye

Abstract

Background Endoscopic cydophotoeoagulation (ECP) combined with phacoemulsification (Phaco) and intraocular lens (IOL) (ECP+ Phaco+ IOL) surgery has been widely used, but its lowing intraocular pressure (IOP) effect is unclear. Objectives This study was to investigate the lowing-IOP effect of ECP+ Phaco+ IOL in chronic glaucoma. Methods This experimental process was approved by Experimental Animal Ethics Committee of Medical College of Nanchang University.Chronic glaucoma models were established bilateral eyes of 30 pigmented rabbits using laser 360°trabecular meshwork photocoagulation.Forty-eight model eyes were randomized to four groups.ECP of 180°, 270° and 360° was performed in the A, B and C groups, respectively, and Phaco+ IOL was simultaneously carried out; while trabeculectomy (Trab) combined with Phaco+ IOL surgery (Trab+ Phaco+ IOL) was performed in the D group.IOP was measured and compared by iCare rebound tonometer before surgery and 1 day, 1 week, 2 weeks, 1 month, 3 months and 6 months after surgery. Results The IOP was(13.31±1.85)mmHg before surgery and that in 1 week after surgery was (33.19±5.59)mmHg, with a significant difference between them (t=94.676, P=0.000). No significant difference was seen among the four groups before operation (P>0.05). The IOP was significantly lower in the C group compared with the A group and B group in postoperative 1 day (P=0.001, 0.035), and in the first week after operation, the IOP was significantly lower in the C group than that of the A group (P=0.013). In the second week after operation, the IOP of the B group was considerably lower than that of the A group, and that of the C group was significant reduced in comparison with the B group (P=0.002, 0.006). The IOP was lowest in the C group in postoperative 1 month in comparison with the A, B and C groups (P=0.001, 0.009, 0.026), and lower IOP was found in the C group compared with the A group in 3 months and 6 months after operation(P=0.008, 0.011). In addition, the lowing-IOP range was larger in the group compared with the A group and B group in 2 weeks and 1 month after operation (2 weeks: P=0.018, 0.014; 1 month: P=0.024, 0.016). No serious complication was found in various groups. Conclusions Both ECP+ Phaco+ IOL and Trab+ Phaco+ IOL can reduce IOP effectively and safely.The lowing-IOP effect is better in larger range of cyclophotocoagulation eye during the ECP+ Phaco+ IOL surgery. Key words: Ciliary body/surgery; Endoscopy; Laser coagulation; Glaucoma/surgery; Trabeculectomy; Intraocular pressure; Cataract/surgery; Phacoemulsification; Lenses, intraocular