Combined Endocyclophotocoagulation and Phacoemulsification in Patients with Glaucoma of African Descent

Abstract 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 ۲۰۱۵ to March ۲۰۱۷. Exclusion criteria consisted of patients who were not of African descent and patients with <۱ month follow-up. IOP was the primary outcome. Thirty-two eyes of ۲۹ patients were included in the study. Mean ± standard deviation (SD) of IOP decreased from ۱۷.۳۰ ± ۶.۳۰ mmHg preoperatively to ۱۵.۸۸ ± ۴.۲۳ mmHg at the last postoperative visit (P = ۰.۳۰۱). In ۲ 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 ۵.۰۵ ± ۴.۰۸ months with a range of ۱ to ۱۸ months. The mean ± SD number of medications used for each patient for IOP control decreased from ۲.۵۹ ± ۱.۰۱ preoperatively to ۱.۹۷ ±۱.۳۸ (P = ۰.۰۴۵). Average visual acuity improved from ۲۰/۵۰ preoperatively to ۲۰/۲۵ (P = ۰.۰۰۲). 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. Epub: October ۱, ۲۰۱۹