By Steven J. Gedde, MD
    Annual Meeting 2013

    Endoscopic cyclophotocoagulation (ECP) is a newer method of cyclophotocoagulation involving laser treatment of the ciliary processes under direct visualization. ECP has been used in managing refractory glaucomas and in pediatric patients, but is most commonly used with phacoemulsification (PE) in eyes with medically controlled or uncontrolled glaucoma. However, the efficacy of PE-ECP is unclear: The relative contribution of PE-ECP in lowering IOP cannot be determined without a comparison group of PE alone. Further, lower rates of surgical complications have been reported with micro-invasive glaucoma surgery (MIGS) combined with PE. Alternative combined procedures, including PE-iStent, PE-Trabectome, PE-canaloplasty, and PE-trabeculectomy, have been validated by well-designed studies.