Efficacy and Safety of Combined Trans-Scleral Cyclophotocoagulation (Tscp) and Phacoemulsification Surgery in Advanced Glaucoma
Journal Title: Ophthalmology and Vision Science - Year 2017, Vol 1, Issue 2
Abstract
Introduction: Previous studies have shown trans-scleral cyclophotocoagulation (TSCP) to be an effective method for controlling intraocular pressure (IOP) in glaucoma. Phacoemulsification (Phaco) has also been shown in some studies to decrease IOP in patients with glaucoma. To our knowledge there are no previous studies evaluating vision and IOP control following combined TSCP and Phaco. Purpose: To assess the effect of combined TSCP and phacoemulsification surgery with respect to a) IOP control, b) visual acuity (VA) c) change in topical therapy and d) side effect profile, in cases of advanced glaucoma. Methods: A retrospective review of 35 eyes of 34 patients undergoing combined TSCPC and phacoemulsification were studied at 12 months. Results: 30 eyes had open angle glaucoma, 4 had mixed mechanism glaucoma and 1 with neovascular glaucoma. The average total energy used was 87.51 J, (Range: 33.75-346 J). Mean pre-treatment IOP was 22.7 mmHg (Range: 16-47 mmHg) and mean IOP at 12 months post treatment was 14.7 mmHg (Range: 0-20 mmHg). This difference was statistically significant, p = 0.00013 (p < 0.05). Mean total medications were reduced from 2.1 to 1.9 (p = 0.55). All patients were able to stop treatment with oral Diamox. At 12 months, visual acuity was better or unchanged in 80% and worse in 20%. Chronic hypotony occurred in only 1 eye which had neovascular glaucoma (NVG). There were no cases of phthisis. Conclusion: Combined TSCP and phacoemulsification is a safe and effective method to control IOP in cases of advanced glaucoma and cataract.
Authors and Affiliations
Ejaz Ansari, Elizabeth D Hawkes
Keywords
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