Comparative Outcomes of Endoscopic Cyclophotocoagulation When Combined With Phacoemulsification in Pseudoexfoliative Versus Primary Open-Angle Glaucoma

Bamefleh DA, Malik R, Aljasim LA, Aldalgan H and Owaidhah O

Published on: 2025-07-24

Abstract

Purpose: To compare the outcomes of endoscopic cyclophotocoagulation (ECP) along with phacoemulsification in eyes with pseudoexfoliative glaucoma (PXFG) versus primary open-angle glaucoma (POAG).

Methods: This retrospective cohort study reviewed cases with PXFG or POAG that underwent combined phacoemulsification and ECP between December 2008 and July 2015 at a tertiary eye center. Data on intraocular pressure (IOP), best-corrected visual acuity (BCVA), glaucoma medications, and the complications were collected. Success was defined as IOP ≤21 mmHg at all visits after 3 months, with or without the use of medications or CPC repeats.

Results: A total of 128 eyes (56 PXFG, 72 POAG) were included. Baseline IOP was higher in PXFG (18.5±6 mmHg) compared to POAG (16.7±4 mmHg; p=0.03). Postoperative IOP reduction was greater in PXFG (3.7±7 mmHg vs 1.4±4 mmHg; p=0.02). Success rates were similar (PXFG: 75%, POAG: 72%; p=0.72). Complication rates were higher in PXFG (16% vs 5%; p=0.0387), with more cases of prolonged uveitis, IOP spikes, and cystoid macular edema. Visual outcomes and medication reduction were comparable between groups.

Conclusions: Phaco-ECP offers a favorable IOP-lowering effect in PXFG comparable to POAG, despite a higher complication rate in PXFG. The procedure is a viable option for reducing medication burden and IOP in both glaucoma subtypes.