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Endoscopic Cyclophotocoagulation Combined with Phacoemulsification Increases Risk of Persistent Anterior Uveitis Compared to Phacoemulsification Surgery Alone

Authors Koduri VA, Reddy AK, Patnaik JL, Palestine AG, Lynch AM, Pantcheva MB

Received 9 December 2020

Accepted for publication 19 January 2021

Published 5 February 2021 Volume 2021:15 Pages 437—443

DOI https://doi.org/10.2147/OPTH.S294791

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Vivek A Koduri, Amit K Reddy, Jennifer L Patnaik, Alan G Palestine, Anne M Lynch, Mina B Pantcheva

Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA

Correspondence: Mina B Pantcheva
Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Court, F731, Aurora, CO, 80045, USA
Tel +1-720-848-2500
Fax +1-720-848-4043
Email mina.pantcheva@cuanschutz.edu

Purpose: To evaluate if the addition of endoscopic cyclophotocoagulation (ECP) to uncomplicated phacoemulsification cataract extraction increases the risk of persistent anterior uveitis (PAU) compared to phacoemulsification alone.
Patients and Methods: Retrospective analysis of patients who had either phacoemulsification alone or combined with endoscopic cyclophotocoagulation from January 1, 2014 to December 31, 2017. Visual acuity, intraocular pressure, presence of anterior chamber cells, and steroid usage were analyzed pre- and post-operatively. Patient eyes with a history of uveitis, autoimmune disease, complicated cataract surgery, combined surgery other than ECP, and less than 3 months of follow-up were excluded.
Results: This study consisted of 4423 eyes from 2903 patients, meeting the inclusion criteria (phacoemulsification only group n=4242 and phacoemulsification/ECP group n=181 eyes). PAU developed in 14.9% in the phacoemulsification with ECP group compared to 1.7% who had phacoemulsification alone. White patients had a 17.9 (95% CI: 7.8– 41.1, p< 0.0001) increased odds of developing persistent anterior uveitis with a combined procedure compared to phacoemulsification only, while Non-white patients had a 5.8 (95% CI: 2.8– 12.1, p< 0.0001) increased odds. Despite the higher odds ratio in White patients, this group had a significantly lower rate of PAU compared to Non-white patients after phacoemulsification/ECP.
Conclusion: The addition of endoscopic cyclophotocoagulation to phacoemulsification significantly increases the risk of developing PAU in the post-operative period compared to phacoemulsification alone.

Keywords: minimally invasive glaucoma surgery, post-operative inflammation

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