Cataract extraction better with ECP

Endoscopic cyclophotocoagulation (ECP) and phacoemulsification cataract extraction, when combined, result in greater reduction of IOP and need for IOP-lowering medications over 3 years compared with cataract extraction by itself. That's according to a study by Brian A. Francis, MD, and colleagues recently published in theJournal of Cataract & Refractive Surgery.

"ECP is the first and most proven MIGS (micro-invasive glaucoma surgery). This study confirms our belief that ECP is a safe and effective adjunct to cataract surgery," said Dr Stanley J. Berke, one of the authors. "The results are encouraging from a clinical standpoint, demonstrating that by addressing glaucoma and cataract simultaneously, we are not only lowering IOP but also reducing the need for glaucoma medications, which results in reducing costs, burden, and side effects to patients."

Researchers studied 80 patients whose eyes had medically controlled open-angle glaucoma and visually significant cataract. The number of glaucoma medications they needed decreased from 1.5 ± 0.8 to 0.4 ± 0.7 (at 1 year and 2 years, respectively). At the 3-year mark, the number of medications required decreased to –0.1 ± 0.8 (n = 45). Mean IOP decreased from 18.1 mmHg ± 3.0 at baseline to 16.0 ± 2.8 mmHg at 1 year, 16.0 ± 3.3 mmHg at 2 years, and 15.4 ± 2.5 at 3 years.

Most eyes that had undergone cataract extraction alone required the same number of medications as previously used or had to use more medications over the long term. Additionally, researchers found that "adding ECP did not increase the risk for serious complications compared with cataract extraction alone."