Combined endoscopic erbium:YAG laser goniopuncture and cataract surgery.

• Abstract: PURPOSE: To study the safety and efficacy of endoscopic erbium:YAG (Er:YAG) laser goniopuncture combined with cataract surgery to treat glaucoma. SETTING: Department of Ophthalmology, Albert-Ludwigs-University Freiburg, Freiburg, Germany, and Institute of Applied Physics, University of Bern, Bern, Switzerland. METHODS: In this nonrandominized clinical trial, 20 eyes of 20 patients with cataract and glaucoma were treated by combined phacoemulsification and Er:YAG goniopuncture. The primary study endpoints were intraocular pressure (IOP), visual acuity, and number of antiglaucoma drugs 1 year after surgery. Two- and 3-year postoperative data were also measured. This prospective treatment arm was compared to a retrospective inclusion-matched control group treated by cataract surgery alone. RESULTS: The mean IOP dropped by 30% (23.5 mm Hg +/- 3.9 [SD] to 16.3 +/- 2.7 mm Hg) after 12 months in the laser-treated group (P<.0001) and by 9% (19.8 +/- 1.3 mm Hg to 18.1 +/- 1.8 mm Hg) in the control group (P =.12). After 3 years, the mean IOP in the laser group was 15.0 +/- 2.0 mm Hg. The mean number of antiglaucoma drugs needed decreased from 1.6 +/- 0.9 to 0.5 +/- 0.8 in the laser group (P<.0001) and from 1.0 +/- 0.9 to 0.8 +/- 0.9 in the control group (P =.21). Anterior chamber hemorrhage occurred in 12 eyes after laser treatment and resolved within 72 hours in all but 1 patient who was on warfarin sodium (Coumadin) therapy. There were no cases of hypotony in either group. CONCLUSIONS: Endoscopic Er:YAG laser goniopuncture was a successful adjunct to cataract surgery in glaucoma patients. Sustained IOP reduction was achieved with few postoperative complications.
• Authors: Nicolas Feltgen, Heiko Mueller, Beat Ott, Martin Frenz, Jens Funk (Affiliation: Department of Ophthalmology, Albert-Ludwigs-University Freiburg, Bern, Switzerland.)
• Journal: Journal of cataract and refractive surgery (J Cataract Refract Surg) Vol. 29 Issue 11 Pg. 2155-62 (Nov 2003) ISSN: 0886-3350 [Print] United States
• PMID: 14670425 (Publication Type: Clinical Conference, Comparative Study, Journal Article)

Chemical References

• Antihypertensive Agents

Topics

• Aged
• Aged, 80 and over
• Antihypertensive Agents (therapeutic use)
• Cataract (complications, therapy)
• Endoscopy
• Glaucoma, Open-Angle (complications, surgery)
• Humans
• Intraocular Pressure
• Laser Therapy (methods)
• Lens Implantation, Intraocular
• Phacoemulsification (methods)
• Prospective Studies
• Safety
• Trabecular Meshwork (surgery)
• Trabeculectomy (methods)
• Treatment Outcome
• Visual Acuity