A study of the efficacy of endoscopic cyclophotocoagulation for the treatment of refractory glaucomas.
BACKGROUND
Endoscopic cyclophotocoagulation (ECP) is a relatively new method of cyclodestruction which can be used in the management of refractory glaucomas.


OBJECTIVE
To evaluate the safety and efficacy of ECP in the management of refractory glaucomas.


METHODS
Prospective interventional non-comparative study.


METHODS
Fifty eyes of 50 patients with refractory glaucoma, whose intraocular pressures (IOP) were not under control with maximal medical therapy underwent ECP, by the anterior, or pars plana route. IOP, best corrected visual acuity (BCVA), and the number of anti-glaucoma medications, were compared postoperatively to preoperative values. Success was defined as IOP pound 22 mmhg, with or without use of medications.


METHODS
Student's t test and repeated measures ANOVA were used to evaluate change in IOP and Student's t test, for comparison of BCVA. Kaplan Meier survival curve was plotted. Wilcoxon signed rank test was used to evaluate reduction in medications.


RESULTS
Patients were followed for an average of 12.27 months (3-21months). IOP decreased significantly from 32.58 +/- 9.16 mmHg to 13.96 +/- 7.71 mmHg at last follow-up ( P < 0.001, student's t test). BCVA was significantly improved in the postoperative period ( P < 0.001, student's t test). The average number of antiglaucoma medications decreased from 2.51 +/- 0.97 to 1.09 +/- 1.16 ( P < 0.001, Wilcoxon signed rank test). ECP had a success rate of 82.2%.


CONCLUSIONS
Endoscopic cyclophotocoagulation is an effective procedure in this subset of refractory glaucomas.
Murthy
Gowri J
GJ
Glaucoma Service, Prabha Eye Clinic and Research Centre and Vittala International Institute of Ophthalmology, Bangalore, India. gowrijmurthy@yahoo.co.in
Murthy
Praveen R
PR
Murthy
Krishna R
KR
Kulkarni
Vinay V
VV
Murthy
K R
KR
D000959:Antihypertensive Agents / Q000008:administration & dosage; D002924:Ciliary Body / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
D000959:Antihypertensive Agents