The clinical study of endoscopic cyclophotocoagulation on the management of refractory glaucoma

Abstract

To evaluate the efficacy and safety of endoscopic cyclophotocoagulation (ECP) in the management of refractory glaucoma. ECP procedures were performed on fifty-one eyes of 47 patients with refractory glaucoma by using the Microprobe (Endo Optiks, URAM E2) integrated laser endoscope system. All patients were followed-up from 6 to 16 months (mean 10.8 months), with four eyes receiving a second treatment. The changes of intraocular pressure (IOP), visual acuity and complication were pre- and post-operatively observed. Compared to preoperation, the IOP of postoperation was significantly (P < 0.01) decreased at week 1, 4, 12, and 24 [(35.3 +/- 13.0) mm Hg (1 mm Hg = 0.133 kPa) vs (19.9 +/- 13.2) mm Hg, (22.0 +/- 11.6) mm Hg, (17.6 +/- 11.6) mm Hg, and (17.0 +/- 10.4) mm Hg, x +/- s, respectively]. The mean number of IOP-decreased drugs used was significantly (P < 0.01) reduced from 3.3 to 1.0 of postoperation. 51.0% of all 51 eyes with the postoperative IOP less than 21 mm Hg did not receive any drug, and 25.5% with supplemental drug treatment. The visual acuity was significantly (P < 0.01) improved postoperatively. Postoperative hyphema were found in 4 eyes, fibrous exudates in 23 eyes, and exudative choroids detachment in 2 eyes, all of which occurred at the early postoperative stage and were healed within 2-16 days. No other complications were observed. ECP is a safe and effective procedure for the management of refractory glaucoma without serious complications.