Images Source: Seibold L, SooHoo J, Kahook M. Endoscopic cyclophotocoagulation. Middle East African Journal of Ophthalmology [Internet]. 2015 [cited 2017 May 9];22(1):18. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4302471/
Inflammation After Endoscopic Cyclophotocoagulation (ECP) Glaucoma Surgery
Endoscopic Cyclophotocoagulation (ECP) is generally thought of as a relatively low risk glaucoma treatment. One potential risk, however, is uveitis (inflammation) of the eye. This inflammation has been reported to occasionally be quite severe after ECP. What is not known is whether there may be characteristics that might predispose someone to experience more severe inflammation after ECP.
At the recent American Glaucoma Society (AGS) 2017 Annual Meeting in San Diego, CA (March 2-5) Dr. Anna M. Edminston and colleagues presented a poster entitled, “Post-operative Inflammation After Endoscopic Cyclophotocoagulation: Racial Distribution and Effect on Outcomes”.
The charts of 276 patients without prior history of persistent anterior uveitis (PAU) who underwent ECP with or without cataract surgery were evaluated. The presence of inflammation three months after surgery was significantly more likely in African Americans than in Asians, Hispanics, or Caucasians. Indeed, almost half of African American patients experienced PAU. Caucasians experienced the lowest incidence of persistent inflammation (16.2%).
The presence of inflammation three months after surgery was significantly more likely in African Americans…
No difference was noted in IOP lowering effect by race or by presence of inflammation.
Fortunately, in this study, inflammation was not associated with a decline in vision. However, persistent inflammation is known to be a risk for loss of vision over time. It would be of interest to know whether PAU was still present and what the vision was six months after Endoscopic Cyclophotocoagulation. This study, however, only reported findings three months after surgery.
- Cohen A, Wong SH, Patel S, Tsai JC. Endoscopic Cyclophotocoagulation for the Treatment of Glaucoma. Surv Ophthalmol. 2016 Oct 5. doi:10.1016/j.survophthal.2016.09.004. [Epub ahead of print]
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About the Author: David Richardson, MD
Medical Director, San Marino Eye
David Richardson, M.D. is widely recognized as one of the top cataract and glaucoma surgeons in the US and is among an elite group of glaucoma surgeons in the country performing the highly specialized canaloplasty procedure. Morever, Dr. Richardson is one of only a few surgeons in the greater Los Angeles area that performs Micropulse® "Cyclophotocoagulation" (MP3) glaucoma laser surgery. Dr. Richardson graduated Magna Cum Laude from University of Southern California and earned his Medical Degree from Harvard Medical School. He completed his ophthalmology residency at the LAC+USC Medical Center/ Doheny Institute. Dr. David Richardson is also an Adjunct Assistant Professor of Clinical Ophthalmology at Keck School of Medicine of USC. Twice weekly, he treats veterans at the VA Greater Los Angeles Veterans Healthcare System.