Endoscopic cyclophotocoagulation (ECP) for glaucoma has benefit over cataract surgery alone in early trial data

Key Takeaways

• A trial suggests that a glaucoma surgery called endoscopic cyclophotocoagulation is more effective than cataract surgery alone for patients with primary open-angle glaucoma.
• More analysis will be needed to confirm the results.

Cyclophotocoagulation refers to glaucoma laser surgeries that target the glands in the eye that produce fluid (aqueous). The goal is to reduce the formation of aqueous and thus lower intraocular pressure. The analogy is turning down the faucet in a sink to decrease the amount of water flowing in. CPC can be divided into endoscopic (those done with a probe inside the eye), or transscleral, (those done with a probe from the outside of the eye) procedures. Endoscopic CPC (ECP) has been around for decades but, according to the authors, there has never been a randomized controlled trial to evaluate its effectiveness in treating glaucoma.

In a Healio video perspective from the 2024 American Society of Cataract and Refractive Surgery meeting, Kim Sheng Lim, MD, discussed the first randomized controlled trial of ECP for primary open-angle glaucoma. Lim and colleagues randomized just over 160 patients with mild to moderate primary open-angle glaucoma (POAG) to receive either cataract surgery alone or cataract surgery with ECP. 

“The early data…suggest that ECP does, in fact, provide additional benefit to cataract surgery alone in terms of IOP control and success rate at 1 year,” Lim said. “Obviously, the final analysis of the data is still to be done — we are awaiting the full statistical analysis — but so far, the data look very encouraging.”

Edited by Miriam Kaplan, PhD

Sources:

Kin Sheng Lim, MD and Alex Young, Healio Ocular Surgery News, April 23, 2024; see source video Brian A. Francis, MD, MS, Glaucoma Research Foundation, “Endoscopic Laser Treatment”, August 2, 2022; see source article