Endoscopic Cyclophotocoagulation (ECP)

1
Endoscopic Cyclophotocoagulation (ECP)

• Zvia Burgansky - Eliash
• The Edith Wolfson Medical Center

2
Trans-scleral CPC
Iliev BJO 2007
3
New Strategy
4
Histology
Lin SC, BJO 2006
5
The Device

• Diode Laser
• Camera
• Light source

6
The Procedure

• Limbal incision
• Usually 2 ports
• 2700

7
The Procedure
8
Own Experience

• 33 eyes, 26 patients
• Procedure
• 10 ECP
• 20 Phaco/ECP
• 3 PPV/ECP

9
Indications
Previous Procedure

• 20 POAG
• 4 CACG
• 2 NVG
• 3 post PK gl
• 2 congenital glaucoma
• 2 traumatic glaucoma

• 1 TCP
• 8 Trabeculectomy
• 2 Valve
• 3 Cataract

10
IOP
  PreOp 1d 1w 2w 6w 3m
IOP 27.8 24.8 21.0 19.3 16.6 17.3
SD 13.6 11.3 12.6 10.5 7.9 10.3
change   -3.0 -7.7 -7.7 -12.7 -13.6
  4.2 22.4 28.9 42.2 41.1
11
of Drops
  Preop 1d 1w 2w 6w 3m
Meds 2.4 0.9 1.9 1.8 1.5 1.3
SD 1.4 1.4 1.3 1.5 1.4 1.6
Change   -1.6 -0.6 -1.1 -0.7 -1.5
12
VA _at_ 3M
  ECP Phaco/ECP
Within 2 snellen lines 6 5
gt 2 snellen lines improvement 1 11
gt 2 snellen lines drop 3  
13
Complications

• One patient
• - significant inflammation after Phaco/ECP
• - resolve with steroid treatment

14
Additional procedure

• 6 eyes needed additional procedure to control IOP
  (5 GDD, 1 TCP)
• Successful reduction in IOP was observed in 27
  eyes (82)

15
Summary

• ECP yield in gt 40 reduction in IOP and 1.5 less
  meds
• Provides a safe and efficient technique for
  glaucoma management
• Can be used together with phaco in marginally
  controlled patients or to avoid medical treatment

16
Phaco/ECP

• 626 Phaco/ECP
• 81 Phaco

Berke AAO 2006
17
Thank you!