ECP effective in the long-term

Endoscopic cyclophotocoagulation (ECP) is an effective approach for the long-term management of difficult glaucoma cases and should be considered as a first-line treatment for refractory glaucoma, according to Francisco Lima, MD speaking at the "Surgery & Lasers in Glaucoma" session.

Dr Lima and colleagues conducted a long-term retrospective study of ECP in refractory glaucomas that included 539 eyes of 485 patients. Each subject underwent one ECP and were followed-up for a minimum five-year period, and retrospectively reviewed. Limbal or pars plana ECP was performed for 210 degrees with scleral depression of the ciliary body.Preoperative IOP was 37.9±6.4 mmHg, diminishing to 15.7±8.5 mmHg. The average number of surgeries preoperatively was 2.2 and the mean number of preoperative medications was 3.9±0.6, reducing postoperatively to 1.5±1.1. Success at one and five years postoperatively (defined as IOP between 5 and 22 mmHg) was 92.6% and 78.8%, respectively. Complications included fibrin exudates (21.5%), failed corneal graft (19.7%), hyphaema (10.7%), immediate postoperative IOP spike (9.8%), choroidal detachment (5.8%), phthisis (2.4%), retinal detachment (1.5%) and hypotony (1.3%).

The authors of this study believe that the results demonstrate the effectiveness of ECP as a long-term management approach for refractory glaucoma and recommend that it be considered as a first-line treatment.