Endoscopic cyclophotocoagulation for the treatment of glaucoma: an Asian experience.
BACKGROUND
To describe the efficacy and safety of endoscopic cyclophotocoagulation in Asian patients with glaucoma.


METHODS
Retrospective case series. Consecutive cases of endoscopic cyclophotocoagulation performed by one surgeon during the study period were included. Patients' records were reviewed for clinical and demographic factors, treatments, intraocular pressure (IOP), visual acuity and any complications.


RESULTS
Twenty-nine eyes of 29 patients were treated. Their mean age was 73.6 +/- 9.4 years. The mean follow-up duration was 15.9 +/- 8.9 months. Eleven patients had primary open-angle glaucoma, two normal tension glaucoma, six chronic angle-closure glaucoma, five neovascular glaucoma, four secondary open-angle glaucoma and one secondary angle-closure glaucoma. Twenty patients had endoscopic cyclophotocoagulation combined with cataract surgery. Mean pretreatment IOP was 21.8 +/- 6.6 mmHg. Mean post-treatment IOP at 18 months (n = 17) was 16.2 +/- 4.1 mmHg (P = 0.02) and 17.9 +/- 4.9 mmHg (P = 0.18) at 24 months (n = 10). The mean number of anti-glaucoma medications pretreatment was reduced from 2.0 +/- 1.0 to 0.9 +/- 0.9 at 18 months post-treatment (P = 0.04) and 1.2 +/- 0.8 at 24 months (P = 0.13). The overall success rate based on IOP reduction of 20% or greater at last follow-up was 48.3%. Visual acuity was reduced in five eyes. Complications included one case each of hyphaema, bullous keratopathy, transient pigment dispersion and iris burn.


CONCLUSIONS
Endoscopic cyclophotocoagulation may have a treatment role in Asian patients with glaucoma. The success rate appears poorer than previously reported in Caucasian populations. The treatment effect appeared to wane between 18 and 24 months post-treatment.
Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore. leonard_yip@ttsh.com.sg
Leonard W
LW
Yip
Shao O
SO
Yong
Arul
A
Earnest
Jian
J
Ji
Boon A
BA
Lim
D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage; D002924:Ciliary Body / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D015812:Glaucoma, Angle-Closure / Q000208:ethnology / Q000503:physiopathology / Q000601:surgery*; D015355:Glaucoma, Neovascular / Q000208:ethnology / Q000503:physiopathology / Q000601:surgery*; D005902:Glaucoma, Open-Angle / Q000208:ethnology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007431:Intraoperative Complications; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012846:Singapore / Q000453:epidemiology; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
D000959:Antihypertensive Agents