title: Combined endoscopic cyclophotocoagulation and phacoemulsification versus phacoemulsification alone in the treatment of mild to moderate glaucoma.
abstract: BACKGROUND
  To evaluate the long-term effects of combined endoscopic cyclophotocoagulation and phacoemulsification (phaco) versus phacoemulsification alone on intraocular pressure control and medication reliance in the treatment of mild to moderate glaucoma.
  
  
  METHODS
  Retrospective chart review in private practice setting by glaucoma fellowship trained surgeons.
  
  
  METHODS
  A total of 261 eyes in the combined phaco-endoscopic cyclophotocoagulation group with 52 eyes in the phaco-alone group.
  
  
  METHODS
  Comparison of phaco-endoscopic cyclophotocoagulation with phaco alone over 36 months.
  
  
  METHODS
  Full and qualified success cumulative survival, intraocular pressure and medication reliance 6-36 months compared with baseline. Full success was defined as minimum 20% intraocular pressure reduction with a decrease of at least one ocular hypertensive medication. Qualified success was defined as intraocular pressure no higher than baseline with a decrease of at least one ocular hypertensive medication.
  
  
  RESULTS
  At 36 months, mean intraocular pressure in the combined phaco-endoscopic cyclophotocoagulation group was 14.6 mmHg, whereas the phaco-alone group was 15.5 mmHg (P = 0.34). Mean medication reliance in the combined phaco-endoscopic cyclophotocoagulation group was 0.2 medications, whereas the phaco-alone group was 1.2 (P < 0.001). Full success in the phaco-endoscopic cyclophotocoagulation group was 61.4%; the phaco-alone group was 23.3% (P < 0.001). Qualified success survival was 72.6% in the phaco-endoscopic cyclophotocoagulation group and 23.3% in the phaco-alone group (P < 0.001).
  
  
  CONCLUSIONS
  Combined phaco-endoscopic cyclophotocoagulation effectively lowers or maintains intraocular pressure and results in ocular hypertensive medication reduction up to 36 months when compared with phaco alone. Therefore, phaco-endoscopic cyclophotocoagulation may help to increase medication compliance and reduce glaucoma progression in mild to moderate glaucoma.
authors: Glaucoma Center of Michigan, Southfield, Michigan, USA.|Kresge Eye Institute, Wayne State University, Detroit, Michigan, USA.|Department of Ophtalmology, William Beaumont Hospital, Royal Oak, Michigan, USA.
authors: Michael J
authors: MJ
authors: Siegel
authors: Glick Eye Institute, Indiana University, Indianapolis, Indiana, USA.|Boling Vision Center, Elkhart, Indiana, USA.
authors: Whitney S
authors: WS
authors: Boling
authors: Connecticut Eye Physicians and Surgeons, PC., Milford, Connecticut, USA.
authors: Omar S
authors: OS
authors: Faridi
authors: Department of Ophtalmology, William Beaumont Hospital, Royal Oak, Michigan, USA.
authors: Chirag K
authors: CK
authors: Gupta
authors: Kresge Eye Institute, Wayne State University, Detroit, Michigan, USA.
authors: Chaesik
authors: C
authors: Kim
authors: Boling Vision Center, Elkhart, Indiana, USA.
authors: Richard C
authors: RC
authors: Boling
authors: Glaucoma Center of Michigan, Southfield, Michigan, USA.|Department of Ophtalmology, William Beaumont Hospital, Royal Oak, Michigan, USA.|Department of Ophthalmology, St. John Providence Hospital-Michigan State University, Madison Heights, Michigan, USA.
authors: Matthew E
authors: ME
authors: Citron
authors: Glaucoma Center of Michigan, Southfield, Michigan, USA.|Department of Ophtalmology, William Beaumont Hospital, Royal Oak, Michigan, USA.
authors: Marc J
authors: MJ
authors: Siegel
authors: Glaucoma Center of Michigan, Southfield, Michigan, USA.|Department of Ophtalmology, William Beaumont Hospital, Royal Oak, Michigan, USA.
authors: Les I
authors: LI
authors: Siegel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002924:Ciliary Body / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D017075:Laser Coagulation / Q000379:methods*; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification / Q000379:methods*; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000959:Antihypertensive Agents
keywords: cataract surgery; combined surgery; glaucoma; iris-ciliary; laser surgery