Abstract
Background: We evaluated the safety and efficacy of endoscopic cyclophotocoagulation (ECP) for eyes with primary open-angle glaucoma (POAG). Methods: We included a total of 104 pseudophakic eyes treated with ECP. Visual acuity and intraocular pressure (IOP, mmHg) measurements were evaluated preoperatively and on days 1 and 7 and 2 and 12 months postoperatively. IOP ≤ 15 or ≥30% reduction from baseline were defined as therapeutic success. Results: The mean baseline IOP was 23.89 ± 8.63, and it decreased significantly at the day 1 (16.25 ± 7.32, p < 0.0001), day 7 (17.81 ± 6.37, p < 0.0001), 2nd month (17.77 ± 8.54, p < 0.0001) and 12th month (16.42 ± 7.05, p < 0.0001) follow-up visits. Therapeutic success was achieved in 55 (61.80%) eyes at the 12-month follow-up. Patients with POAG duration longer than 10 years or those using alpha agonist eye drops had a lower rate of therapeutic success (odds ratio: 0.52, 95% CI = 0.32–0.85, p < 0.05 and odds ratio: 0.92, 95% CI = 0.55–0.95, p = 0.024, respectively). A longer disease course was associated with higher IOP values (Rs =+0.281; p = 0.024) postoperatively. The number of antiglaucoma medications decreased significantly from 2.55 ± 1.16 to 2.11 ± 1.14 (p = 0.003). The ECP complications included a minor IOP increase (9.37%), pupil irregularity (15.73%), and the presence of fibrin (3.29%). Conclusions: The ECP is an effective and safe option, especially in eyes with a shorter glaucoma course.
Highlights
Endoscopic cyclophotocoagulation (ECP) with clear corneal access or through the pars plana of the ciliary body is a modification of the well-established transscleral cyclophotocoagulation (TCP) procedure
Patients with primary open-angle glaucoma (POAG) duration longer than 10 years or those using alpha agonist eye drops had a lower rate of therapeutic success
Evidence of the impact of isolated ECP on intraocular pressure (IOP) is missing, several studies have described a substantial reduction in IOP as a result of an ECP procedure combined with cataract extraction
Summary
Endoscopic cyclophotocoagulation (ECP) with clear corneal access or through the pars plana of the ciliary body is a modification of the well-established transscleral cyclophotocoagulation (TCP) procedure. The advantage of this approach over standard TCP and both micropulse and ultrasound cyclophotocoagulation (MCP) is the precise vision-guided destruction of a certain number of ciliary processes. We evaluated the safety and efficacy of endoscopic cyclophotocoagulation (ECP) for eyes with primary open-angle glaucoma (POAG). Therapeutic success was achieved in 55 (61.80%) eyes at the 12-month follow-up. The ECP complications included a minor IOP increase (9.37%), pupil irregularity (15.73%), and the presence of fibrin (3.29%). Conclusions: The ECP is an effective and safe option, especially in eyes with a shorter glaucoma course
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