title: Intraocular Pressure Following Phacoemulsification and Endoscopic Cyclophotocoagulation for Advanced Glaucoma: 1-Year Outcomes.
abstract: OBJECTIVE
  To evaluate changes in intraocular pressure (IOP), vision, and medications at least 1 year after phacoemulsification combined with endocyclophotocoagulation for advanced glaucoma and cataract.
  
  
  METHODS
  A retrospective chart review was conducted on patients with advanced glaucoma who underwent phacoemulsification combined with endocyclophotocoagulation at King Khaled Eye Specialist Hospital between 2005 and 2012. Data were collected on patient demographics, type of glaucoma, IOP over time, best-corrected visual acuity, number of glaucoma medications, comorbidities, and previous surgeries. Absolute success was defined as IOP≤15 mm Hg without medication and qualified success was IOP≤15 mm Hg with medications. Statistical significance was indicated by P<0.05.
  
  
  RESULTS
  The study sample comprised 104 eyes (104 patients). Mean follow-up was 17.3±1.8 months. Mean IOP decreased from 17±1.4 mm Hg preoperatively to 14.7±1.3 mm Hg at the last postoperative visit. Absolute success was achieved in 11.9% (95% confidence interval, 5.6-18.2) of the eyes. Qualified success was achieved in 72.3% (95% confidence interval, 63.5-81.0) of the eyes. Best-corrected visual acuity improved by ≥2 lines in 76 (73%) eyes. Eyes with primary open-angle glaucoma had the higher absolute and qualified success rates compared with primary angle-closure and pseudoexfoliation glaucoma (P>0.05). Only 48 (46%) patients required >3 medications for IOP control compared with 78 (75%) patients before surgery.
  
  
  CONCLUSIONS
  At ≥1 year postoperatively, the absolute success rate of treating advanced glaucoma by endocyclophotocoagulation and phacoemulsification was low. However, medication burden was reduced. Owing to the significant variation in the success rate based on the type of glaucoma, patients with advanced glaucoma should be carefully selected and counseled.
authors: *King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia †Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD.
authors: Jose
authors: J
authors: Morales
authors: Masaoud
authors: M
authors: Al Qahtani
authors: Rajiv
authors: R
authors: Khandekar
authors: Sami
authors: S
authors: Al Shahwan
authors: Sami
authors: S
authors: Al Odhayb
authors: Faisal
authors: F
authors: Al Mobarak
authors: Deepak P
authors: DP
authors: Edward
mesh_terms: D000328:Adult; D000368:Aged; D002386:Cataract / Q000150:complications; D002924:Ciliary Body / Q000601:surgery*; D004724:Endoscopy; D017889:Exfoliation Syndrome / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011184:Postoperative Period; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology