Long Term Efficacy and Safety of Endocyclophotocoagulation Combined with Phacoemulsification in Asian Eyes- A Case Series Study

Purposes: A case series study of the long-term efficacy and safety of Endocyclophotocoagulation combined with phacoemulsification on Asian eyes with cataract and glaucoma. Significance: Cataract surgery alone can reduce intraocular pressure. However, many confirmed glaucoma cases withcataract that just perform cataract surgery alone cannot lower IOP enough to target pressure. Many Asian glaucomatic eyes have narrow angle component to inhibit aqueous out-flow, while angle procedures will be unable to perform. Combining cataract surgery with Endocyclophotocoagulation was reported can further reducing intraocular pressure. This study, to our knowledge, may be represents the longest follow-up of Endocyclophotocoagulation combined with phacoemulsification in Asian eyes with glaucoma. Method: A random chart review of 41 Asian eyes of 41 patients with various types and severity of glaucoma and cataract that underwent Endocyclophotocoagulation combined with phacoemulsification from 2012 to 2024 with various period of follow up by a single surgeon at a single center with a single laser machine In Honolulu, USA. Preoperative and postoperative mean intraocular pressures (IOP) were compared. Results: No complications related to Endocyclophotocoagulation were reported in all of the 41 eyes. IOP were checked by a single calibrated automatic non-contact tonometry two weeks before and two weeks after surgery. In order to effectively control various severities of glaucoma depending on the vision, visual field and optic nerve of the eyes, a target intraocular pressure has to be established and reached. Therefore, 44% of eyes needed eye medication and 40% need eye needed medication and further procedures after the surgery. 17% were free from medication and procedure to be on target IOP. Comparison showed those severe cases that needed medication and procedures pre-op and post -op had Endocyclophotocoagulation demonstrated statistically significant lower mean IOP. Mean IOP (SD) in mmHg for all subjects (n = 41): P