One-site versus two-site endoscopic cyclophotocoagulation

Purpose: To report the intraocular pressure (IOP) lowering effect of endoscopic cyclophotocoagulation (ECP) treatment through 1 versus 2 corneal incisions. Methods: This is a retrospective consecutive case review of combined ECP and phacoemulsification (PE). Group 1 included patients undergoing PE-ECP through 1 clear cornea incision and group 2 involved PE followed by ECP through 2 incisions. The I versus 2 site selection was performed in a nonrandomized fashion at the time of surgery. Data including age, sex, preoperative diagnosis, number of preoperative and postoperative glaucoma medications, complications, treatment failures, and IOP were collected and analyzed using analysis of variance and t tests where appropriate. Results: Group 1 included 15 patients and group 2 included 25 patients. Age of patients in group 1 (66.07 +/- 17.73) and group 2 (73.48 +/- 11.31) were similar (P = 0.11). Visual acuity in group 1 ranged from 20/40 to 20/400 and from 20/40 to counting fingers in group 2. The preoperative diagnoses were similar between the 2 groups. Preoperative IOP was 23.60 +/- 3.89 in group 1 and 24.48 +/- 8.99 in group 2 (P = 0.72). IOP decreased in group 1 from 23.60 +/- 3.89 to 17.93 +/- 4.38 (P = 0.0008) and in group 2 from 24.48 +/- 8.99 to 13.88 +/- 3.22 (P = 0.00001) with 3 months of follow-up. IOP at 3 months was significantly lower in group 2 compared with group 1 (P = 0.002). Six-month IOP data for group 1 (16.00 +/- 2.77) and group 2 (13.00 +/- 3.09) remained statistically significant in favor of 2-site PE-ECP (P = 0.04). Glaucoma medication use decreased more in group 2 (2.56 +/- 0.71 to 0.52 +/- 0.59) versus group 1 (2.47 +/- 0.74 to 1.93 +/- 0.88) (P = 0.00001). Conclusions: Two-site PE-ECP may result in statistically significant IOP lowering and less dependence on glaucoma medications compared with single site PE-ECP.