Combining phacoemulsification with micropulse transscleral cyclophotocoagulation (MP-TSCPC) can reduce intraocular pressure (IOP) in patients with glaucoma, perhaps better than cataract surgery alone, according to a study published in Eye. It also lowers the number of glaucoma medications patients will need at 6 and 12 months postoperatively, and help most patients achieve stable or better vision at 12 months.
The retrospective case-note review was the first study examining the effect of cataract surgery and micropulse cyclodiode laser in glaucoma patients. It looked at 42 eyes, 34 of which reached 12 months follow-up, of adult patients with glaucoma and cataracts. Individuals studied needed further reduction in IOP or reduction in glaucoma drop amount. The procedures’ effects on visual acuity (VA), IOP, and number of antiglaucoma drops at 6 and 12 months, as well as any complications that arose during the study, were evaluated.
Researchers found that mean IOP was reduced from 19.5±5.4 mm Hg by 22.5% to 15.1±4.6 at 6 months postoperatively and by 19.5% to 15±6.6 mm Hg at 12 months (P <.001 at both time points). Reduction was significant for the amount of antiglaucoma medications, from 2.8±1.3 to 1.6±1.2 at 6 months to 2.2±1.3 at 12 months (P <.001 at both time points). Success rate was 56% at 6 months and 54% at 12 months. A total of 54.7% of patients who completed 12 months follow-up had an improvement or unchanged vision at their last visits.
“Our study demonstrated that 42.8% of our patients who completed 12 months follow up had an improvement in their visual acuity by 1 line or more, 11.9% had unchanged vision and 26.1% (11 patients) had worsening in their vision. We explored the patients who had worsening in vision and found: 2 patients had further glaucoma filtrating surgeries, 2 patients had [cystoid macular edema], 1 patient had persistent inflammation, and 1 patient had posterior capsular opacification at 12 months follow up,” researchers report.
Daas A, Sherman T, Danieliute L, et al. Phacoemulsification combined with micropulse cyclodiode laser in glaucoma patients: efficacy and safety. Eye. Published online November 6, 2021. doi:10.1038/s41433-021-01826-1