Abstract:AIM: To analyze the clinical value of phacoemulsification and intraocular lens implantation(Phaco+IOL)combined with endoscopic cyclophotocoagulation(ECP)in the treatment of patients with glaucoma and cataract.
METHODS: Between January and December 2019, 58 patients(64 eyes)with primary glaucoma and cataract diagnosed and treated in Ophthalmology Department of the hospital were enrolled in this study. According to the patients' and their family members' willingness, the study subjects were divided into ECP group(27 cases, 30 eyes, Phaco+IOL+ECP)and trabeculectomy(TRAB)group(31 cases, 34 eyes, Phaco+IOL+TRAB). Surgical results, changes in visual acuity, intraocular pressure, corneal endothelial cells, and optical coherence tomography(OCT)parameter were compared between the two groups.
RESULTS: The complete success rate of surgery in ECP group was 83%, higher than 59% in TRAB group(P<0.05). After surgery, visual acuity of the two groups was improved, and intraocular pressure was reduced(P<0.05), without statistical difference between groups(P>0.05). After surgery, the coefficient of variation of corneal endothelial area, proportion of hexagonal cells, average cellular area, and central corneal thickness of ECP group were lower and smaller than those of TRAB group, while corneal endothelial cell density was higher than TRAB group(P<0.05). After surgery, anterior chamber depth(ACD), angular opening distance 500(AOD500), trabecular iris angle(TIA), and angular recess area(ARA)were increased in the two groups(P<0.05), without statistically significant differences between groups(P>0.05). The incidence of ocular hypertension requiring drug control and the total incidence of ocular hypertension were significantly lower in ECP group than in TRAB group(all P<0.05).
CONCLUSION: Compared with TRAB, ECP can achieve a higher complete success rate in the treatment of glaucoma with cataract, with less influence on corneal cells.
