Combined Endocyclophotocoagulation and Phacoemulsification in Patients with Glaucoma of African Descent

The aim of this study was to evaluate the outcomes of combined endocyclophotocoagulation (ECP) and phacoemulsification regarding vision, refraction, intraocular pressure (IOP), medication dependence, and complications in patients of African descent. A retrospective chart review was performed includi...

Descripción completa

Detalles Bibliográficos
Autores principales: Waldman, Corey W., Desai, Manishi, Rahman, Effie Z., Eliassi-Rad, Babak
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medical Hypothesis, Discovery & Innovation Ophthalmology 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6778678/
https://www.ncbi.nlm.nih.gov/pubmed/31788486
_version_ 1783456806468583424
author Waldman, Corey W.
Desai, Manishi
Rahman, Effie Z.
Eliassi-Rad, Babak
author_facet Waldman, Corey W.
Desai, Manishi
Rahman, Effie Z.
Eliassi-Rad, Babak
author_sort Waldman, Corey W.
collection PubMed
description The aim of this study was to evaluate the outcomes of combined endocyclophotocoagulation (ECP) and phacoemulsification regarding vision, refraction, intraocular pressure (IOP), medication dependence, and complications in patients of African descent. A retrospective chart review was performed including all cases of ECP combined with phacoemulsification from October 2015 to March 2017. Exclusion criteria consisted of patients who were not of African descent and patients with <1 month follow-up. IOP was the primary outcome. Thirty-two eyes of 29 patients were included in the study. Mean ± standard deviation (SD) of IOP decreased from 17.30 ± 6.30 mmHg preoperatively to 15.88 ± 4.23 mmHg at the last postoperative visit (P = 0.301). In 2 of eight patients who did not demonstrate a difference in pre- and postoperative IOP changes, all IOP lowering medications were stopped. The mean ± SD of follow-up was 5.05 ± 4.08 months with a range of 1 to 18 months. The mean ± SD number of medications used for each patient for IOP control decreased from 2.59 ± 1.01 preoperatively to 1.97 ±1.38 (P = 0.045). Average visual acuity improved from 20/50 preoperatively to 20/25 (P = 0.002). Postoperative complication rate was low. ECP combined with phacoemulsification was effective to decrease IOP lowering medication dependence in patients of African descent. We found that combined ECP and phacoemulsification can lead to a significantly decreased dependence on IOP lowering drops, with some patients demonstrating complete independence from drops following surgery. Although there was not a significant decrease in IOP postoperatively when analyzed collectively, larger studies might to find such an association. Combined ECP and phacoemulsification has been shown to be a safe combination in patients with refractive glaucoma and may be considered if a patient desire less dependence on IOP lowering drops once other first-line methods have failed, or as a bridge between conservative and more definitive surgical treatment.
format Online
Article
Text
id pubmed-6778678
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Medical Hypothesis, Discovery & Innovation Ophthalmology
record_format MEDLINE/PubMed
spelling pubmed-67786782019-12-01 Combined Endocyclophotocoagulation and Phacoemulsification in Patients with Glaucoma of African Descent Waldman, Corey W. Desai, Manishi Rahman, Effie Z. Eliassi-Rad, Babak Med Hypothesis Discov Innov Ophthalmol Original Article The aim of this study was to evaluate the outcomes of combined endocyclophotocoagulation (ECP) and phacoemulsification regarding vision, refraction, intraocular pressure (IOP), medication dependence, and complications in patients of African descent. A retrospective chart review was performed including all cases of ECP combined with phacoemulsification from October 2015 to March 2017. Exclusion criteria consisted of patients who were not of African descent and patients with <1 month follow-up. IOP was the primary outcome. Thirty-two eyes of 29 patients were included in the study. Mean ± standard deviation (SD) of IOP decreased from 17.30 ± 6.30 mmHg preoperatively to 15.88 ± 4.23 mmHg at the last postoperative visit (P = 0.301). In 2 of eight patients who did not demonstrate a difference in pre- and postoperative IOP changes, all IOP lowering medications were stopped. The mean ± SD of follow-up was 5.05 ± 4.08 months with a range of 1 to 18 months. The mean ± SD number of medications used for each patient for IOP control decreased from 2.59 ± 1.01 preoperatively to 1.97 ±1.38 (P = 0.045). Average visual acuity improved from 20/50 preoperatively to 20/25 (P = 0.002). Postoperative complication rate was low. ECP combined with phacoemulsification was effective to decrease IOP lowering medication dependence in patients of African descent. We found that combined ECP and phacoemulsification can lead to a significantly decreased dependence on IOP lowering drops, with some patients demonstrating complete independence from drops following surgery. Although there was not a significant decrease in IOP postoperatively when analyzed collectively, larger studies might to find such an association. Combined ECP and phacoemulsification has been shown to be a safe combination in patients with refractive glaucoma and may be considered if a patient desire less dependence on IOP lowering drops once other first-line methods have failed, or as a bridge between conservative and more definitive surgical treatment. Medical Hypothesis, Discovery & Innovation Ophthalmology 2019 2019-10-01 /pmc/articles/PMC6778678/ /pubmed/31788486 Text en © 2019, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International License (http://creativecommons.org/licenses/by/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
spellingShingle Original Article
Waldman, Corey W.
Desai, Manishi
Rahman, Effie Z.
Eliassi-Rad, Babak
Combined Endocyclophotocoagulation and Phacoemulsification in Patients with Glaucoma of African Descent
title Combined Endocyclophotocoagulation and Phacoemulsification in Patients with Glaucoma of African Descent
title_full Combined Endocyclophotocoagulation and Phacoemulsification in Patients with Glaucoma of African Descent
title_fullStr Combined Endocyclophotocoagulation and Phacoemulsification in Patients with Glaucoma of African Descent
title_full_unstemmed Combined Endocyclophotocoagulation and Phacoemulsification in Patients with Glaucoma of African Descent
title_short Combined Endocyclophotocoagulation and Phacoemulsification in Patients with Glaucoma of African Descent
title_sort combined endocyclophotocoagulation and phacoemulsification in patients with glaucoma of african descent
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6778678/
https://www.ncbi.nlm.nih.gov/pubmed/31788486
work_keys_str_mv AT waldmancoreyw combinedendocyclophotocoagulationandphacoemulsificationinpatientswithglaucomaofafricandescent
AT desaimanishi combinedendocyclophotocoagulationandphacoemulsificationinpatientswithglaucomaofafricandescent
AT rahmaneffiez combinedendocyclophotocoagulationandphacoemulsificationinpatientswithglaucomaofafricandescent
AT eliassiradbabak combinedendocyclophotocoagulationandphacoemulsificationinpatientswithglaucomaofafricandescent