All forms of cyclophotocoagulation have been shown to lower IOP. A randomized study comparing continuous and discrete external cyclophotocoagulation showed a similar reduction in IOP, number of glaucoma medications, and retreatment rates at 18 months.
No prospective randomized study has shown that cataract surgery combined with ECP is more effective than cataract surgery alone, although a prospective nonrandomized study and a retrospective study have done so. These procedures often need to be repeated, as their IOP-lowering effect diminishes over time.
Aquino MC, Barton K, Tan AM, et al. Micropulse versus continuous wave transscleral diode cyclophotocoagulation in refractory glaucoma: a randomized exploratory study. Clin Exp Ophthalmol. 2015;43(1):40–46.
Francis BA, Berke SJ, Dustin L, Noecker R. Endoscopic cyclophotocoagulation combined with phacoemulsification versus phacoemulsification alone in medically controlled glaucoma. J Cataract Refract Surg. 2014;40(8):1313–1321.
Pérez Bartolomé F, Rodrigues IA, Goyal S, et al. Phacoemulsification plus endoscopic cyclophotocoagulation versus phacoemulsification alone in primary open-angle glaucoma. Eur J Ophthalmol. 2018;28(2):168–174.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.