| Popis: |
Background: To evaluate the outcomes of combined endocyclophotocoagulation (ECP) and phacoemusification in regards to vision, refraction, intraocular pressure, medication dependence, and complications in patients of African descent at a tertiary care glaucoma practice. Methods: A retrospective chart review including all cases of ECP combined with phacoemulsification cataract surgery from October 2015 to March 2017 was performed. Exclusion criteria consisted of patients who were not of African descent and patients with < 1 month follow up. The primary outcome measured was IOP at the latest follow-up. Results: 32 eyes of 29 patients were included in the study. Average IOP decreased from 17.30 ±6.30 mmHg preoperatively to 15.88 ±4.23 mmHg at the last post-operative visit (p = 0.301). 2/8 patients who did not demonstrate a difference in pre- and post-operative IOP changes were able to be weaned off all of their IOP lowering medications. The average follow-up was 5.05 ± 4.08 months with a range of 1 to 18 months. The average number of medications used per 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 an average of 20/25 (p = 0.002). The post-operative complication rate was low. Conclusions: ECP combined with phacoemulsification can be effective at decreasing IOP lowering medication dependence in patients of African descent while also demonstrating variable IOP outcomes. While some patients with primary open angle glaucoma (POAG) and prior glaucoma surgery may experience a robust response to this treatment, others may not. 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 post-operatively when analyzed collectively, larger studies may be able 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 desires less dependence on IOP lowering drops once other first-line methods have failed, or as a bridge between conservative and more definitive surgical treatment. Keywords: Endocyclophotocoagulation, phacoemusification, African decent |
