Competing/conflicts of interest: No stated conflict of interest.
Combining phacoemulsification with endoscopic cyclophotocoagulation to manage cataract and glaucoma
Version of Record online: 24 JAN 2013
© 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists
Clinical & Experimental Ophthalmology
Volume 41, Issue 6, pages 546–551, August 2013
How to Cite
Clement, C. I., Kampougeris, G., Ahmed, F., Cordeiro, M. F. and Bloom, P. A. (2013), Combining phacoemulsification with endoscopic cyclophotocoagulation to manage cataract and glaucoma. Clinical & Experimental Ophthalmology, 41: 546–551. doi: 10.1111/ceo.12051
Funding sources: MF Cordeiro receives consultancy fees and research funding from Heidelberg Engineering and Zeiss.
- Issue online: 31 JUL 2013
- Version of Record online: 24 JAN 2013
- Accepted manuscript online: 10 DEC 2012 06:26AM EST
- Manuscript Accepted: 8 NOV 2012
- Manuscript Received: 24 SEP 2012
- Heidelberg Engineering and Zeiss
- intraocular pressure
To examine the outcome and complications of combined phacoemulsification and endoscopic cyclophotocoagulation as surgical management of cataract and glaucoma.
Retrospective uncontrolled case series from the glaucoma unit, Western Eye Hospital, London, UK.
Sixty-three eyes from 59 patients with coexisting cataract and glaucoma.
Patients underwent routine phacoemulsification followed by 270–360 degree endoscopic cyclophotocoagulation as a single procedure.
Main Outcome Measures
Intraocular pressure, number of intraocular pressure-lowering medications, logMAR visual acuity, recorded complications.
Baseline characteristics included mean age (77.3 ± 11.1 years), mean logMAR visual acuity (1.01 ± 0.98), mean intraocular pressure (21.13 ± 6.21 mmHg) and mean number of intraocular pressure-lowering medications, (2.71 ± 1.06). Twelve months after phacoemulsification and endoscopic cyclophotocoagulation, mean intraocular pressure had reduced to 16.09 ± 5.27 mmHg (P < 0.01), number of intraocular pressure-lowering medications reduced to 1.47 ± 1.30 (P < 0.01) and mean logMAR acuity improved to 0.33 ± 0.22 (P < 0.01). Success, defined as an intraocular pressure reduction > 20% with intraocular pressure 6–21 mmHg, was achieved in 55.5% of eyes at 12 months. Complications included fibrinous uveitis, elevated intraocular pressure, posterior vitreous detachment and induced astigmatism.
Phacoemulsification and endoscopic cyclophotocoagulation is both safe and effective as surgical management for cataract and glaucoma. Larger intraocular pressure reductions can be achieved in older patients and those with higher baseline intraocular pressure.