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Efficacy of combined cataract extraction and endoscopic cyclophotocoagulation for the reduction of intraocular pressure and medication burden

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International Journal of Ophthalmology(English edition) 2016年第5期9卷 693-698页

作者： Sammie J.Roberts Matthew Mulvahill Jeffrey R.SooHoo Mina B.Pantcheva Malik Y.Kahook Leonard K.Seibold Department of Ophthalmology University of Colorado School of MedicineAnschutz Medical Campus Department of Biostatistics University of ColoradoAnschutz Medical Campus

AIM： To report on the efficacy of combined endoscopic cyclophotocoagulation（ECP） and phacoemulsification cataract extraction（PCE） with intraocular lens placement for reduction of intraocular pressure（IOP） and medication burden in glaucoma.·METHODS： A retrospective case review of 91 eyes（73patients） with glaucoma and cataract that underwent combined PCE/ECP surgery was performed. Baseline demographic and ocular characteristics were recorded,as well as intraocular pressure, number of glaucoma medications, and visual acuity postoperatively with 12-month follow-up. Treatment failure was defined as less than 20% reduction in IOP from baseline on two consecutive visits（at 1, 3, 6, or 12 mo postoperatively）,IOP ≥21 mm Hg or ≤5 mm Hg on two consecutive visits, or additional glaucoma surgery performed within12 mo after PCE/ECP.·RESULTS： Overall, mean medicated IOP was reduced from 16.65 mm Hg at baseline to 13.38 mm Hg at 12mo（P 0.0001）. Mean number of glaucoma medications was reduced from 1.88 medications at baseline to 1.48 medications at 12mo（P =0.0003）. At 3mo postoperatively,the success rate was 73.6%（95%CI： 63.3, 81.5）, 57.1% at6mo（95% CI： 46.3, 66.6）, and 49.7% at 12mo（95% CI：38.9, 59.6）. Patient demographic characteristics were not associated with treatment success. The only ocular characteristic associated with treatment success was a higher baseline IOP.· CONCLUSION： Combined PCE/ECP surgery is an effective surgical option for the reduction of IOP and medication burden in glaucoma patients. Patients withhigher baseline IOP levels are most likely to benefit from this procedure.

关键词： endoscopic cyclophotocoagulation glaucoma cataract extraction

Combined phacoemulsification and goniosynechialysis with or without endoscopic cyclophotocoagulation in the treatment of PACG with cataract

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International Journal of Ophthalmology(English edition) 2020年第9期13卷 1385-1390页

作者： Wan-Shu Zhou Wen-Xiang Lin Yun-Yun Geng Tao Wang Beijing Tongren Eye Center Beijing Key Laboratory of Ophthalmology and Visual SciencesBeijing Tongren HospitalCapital Medical UniversityBeijing 100730China

AIM:To investigate the efficacy and safety of combined phacoemulsification and goniosynechialysis with or without endoscopic cyclophotocoagulation(PGE group and PG group)for the treatment of patients with coexisting primary angle-closure glaucoma(PACG)and ***:The clinical data of patients with PACG and cataract were retrospectively *** was a total of 88 eyes in the study and were divided into two groups,42 eyes in PGE group and 46 eyes in PG *** success cumulative survival,preoperative and postoperative intraocular pressure(IOP),number of IOPlowering medications,best corrected visual acuity(BCVA)in the two groups were observed for more than 12 mo and compared within each group and between two ***:The mean IOP in PGE group declined from24.9 mm Hg preoperatively to 14.1 mm Hg at the first month after operation(P<0.001)and at the last visit 16.2 mm Hg(P<0.001).Meanwhile PG group also showed significant decrease,from 24.1 mm Hg preoperatively to 13.0 mm Hg at Imo after operation(P<0.001)and 15.3 mm Hg at the last visit(P=0.004).The mean medications reliance reduced in both groups,in PGE group was reduced from 1.62 preoperatively to 0.13 at the last visit(P<0.001),in PG group from 0.87 to 0.10(P<0.001).At the last visit,BCVA increased from 0.21 to 0.60 in PGE group(P<0.001)and from 0.24 to 0.67 in PG group(P<0.001).The success rate of PGE group at 1 mo was95.2%,then decreased to 70.7%at the last visit,whereas in PG group,the success rate at 1 mo was 100%,at the last visit was 73.4%.CONCLUSION:PGE shows promise for PACG patients with cataracts to reduce IOP,lighten the medication burden and improve visual acuity,and PG still has its value in specific patients.

关键词： endoscopic cyclophotocoagulation primary angle-closure glaucoma cataract combined glaucoma and cataract surgery laser surgery

Outcomes of vitrectomy,complete pan-retinal photocoagulation,and endoscopic cyclophotocoagulation surgery after anti-VEGF treatment in neovascular glaucoma

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Advances in Ophthalmology Practice and Research 2023年第3期3卷 112-118页

作者： Jinglan Li Siwenyue Zhang Baoke Hou Medical School of Chinese PLA BeijingChina Senior Department of Ophthalmology The Third Medical Center of PLA General HospitalBeijingChina

Purpose:To establish a comprehensive treatment strategy and evaluate the efficacy of combination of anti-vascular endothelial growth factor(VEGF)injection,pars plana vitrectomy(PPV),endoscopic pan-retinal photocoagulation(PRP),and endoscopic cyclophotocoagulation(ECP)surgery for neovascular glaucoma(NVG)***:This retrospective study included 30 patients(30 eyes)who were suffering from NVG and treated with PPV&PRP&ECP(ECP group,16 eyes),or Ahmed glaucoma valve implantation(Ahmed group,14 eyes).The intraocular pressure(IOP),number of postoperative anti-glaucoma medications,best-corrected visual acuity(BCVA),successful rate of surgery,and postoperative complications were recorded and statistically analyzed at the time points of preoperative,1-day,1-month,3-months,6-months,and 12-months after ***:An obvious reduction in IOP and number of postoperative anti-glaucoma medications were observed in both the ECP group and Ahmed group after operation(P0.05),while it was significantly improved in ECP group at 3-months(P=0.001),6-months(P=0.004),and 12-months(P=0.010)time points comparing with preoperative *** surgical success rates in ECP group were also slightly higher than Ahmed *** the complications after operation showed no marked ***:The comprehensive treatment of PPV,endoscopic PRP,and ECP surgery for NVG patients after antiVEGF injection can control IOP effectively and be friendly to patients’BCVA without obvious serious complications throughout a 12-months follow-up period.

关键词： Neovascular glaucoma endoscopic cyclophotocoagulation Pars plana vitrectomy Pan-retinal photocoagulation Anti-VEGF

Bleb-associated endophthalmitis treated by sclera patch graft, vitrectomy and endoscopic cyclophotocoagulation

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Chinese Medical Journal 2012年第18期125卷 3344-3345页

作者： ZHENG Peng-fei PANG Xiu-qin Beijing Tongren Eye Center Beijing Tongren Hospital CapitalMedical University China Beijing 100730

Background Bleb-associated endophthalmitis （BAE） is a rare but severe complication of trabeculectomy with poor outcome. Various surgical methods were explored to treat such patients. However, there is no defined protocol. The aim of this study was to describe a new combined operation, and to demonstrate the outcome of the treatment. Methods Nine patients with BAE were enrolled in our study. The combined operation including pars plana vitrectomy （PPV）, sclera patch graft （SPG） and endoscopic cyclophotocoagulation （ECP） was used to treat these patients. Results In the follow-up of 18-24 months, all patients with the endophthalmitis were cured, the useful visual acuity was preserved in 7 patients, and the intraocular pressure （lOP） of 8 patients was controlled just after first operation, only one needed another trans-scleral cyclophotocoagulation. Conclusion This combined operation is a useful method for treating the patients with BAE, with SPG and vitrectomy to control the endophthalmitis and ECP to balance the postoperative lOP.

关键词： bleb-associated endophthalmitis sclera patch graft," vitrectomy endoscopic cyclophotocoagulation