EFFICACY AND SAFETY OF ENDOSCOPIC CYCLOPHOTOCOAGULATION VERSUS TRANSSCLERAL CYCLOPHOTOCOAGULATION IN THE TREATMENT OF ADULTS WITH GLAUCOMA: A SYSTEMATIC REVIEW AND META-ANALYSIS
Published 2025 - 29th ESCRS Winter Meeting
Reference: PO099 | Type: Free Paper | DOI: 10.82333/mfkq-m081
Authors: Saad Alosaimi* 1 , Ahmad Alhabash 2 , Medhat Bakr 1
1Department of Ophthalmology,King Fahad University Hospital,Khober,Saudi Arabia, 2Ophthalmology resident,King Fahad University Hospital,Khober,Saudi Arabia
Purpose
In cyclophotocoagulation, the laser is administered via either a transscleral or endoscopic method targeting the ciliary processes to reduce aqueous output. In the current systematic review and meta-analysis, we aimed to compare between endoscopic cyclophotocoagulation (ECP), and transscleral cyclophotocoagulation (TCP) regarding efficacy and safety in glaucoma patients.
Setting
Systematic Review and Meta-analysis
Methods
Methods: We searched PubMed, Web of Science, and Scopus for articles comparing ECP and TCP in glaucoma patients using the following search strategy: “Endoscopic” AND “Cyclophotocoagulation” AND “Transscleral” from inception till September 2024. We used mean difference (MD) for continuous variables to compare ECP and TCP in the change from baseline values, between baseline and posttreatment values, and odds ratio (OR) for dichotomous variables at a 95% confidence interval (CI).
Results
Results: TCP was significantly associated with higher reduction in IOP compared with ECP at 3-, 6-, and 12-month measurements with MD= 5.65 (95%CI: 2.69, 8.61, p=0.0002), MD= 4.05 (95%CI: 2.01, 6.08, p<0.0001), and MD= 3.5 (95%CI: 1.52, 5.48, p=0.0005. However, no significant difference was observed between both groups regarding the number of glaucoma medications at the 3 measurement periods. No significant difference was observed between both groups regarding complications (OR= 1.27, 95%CI: 0.62, 2.6, p=0.51) and macular edema (OR= 2.72, 95%CI: 0.95, 7.82, p=0.06). ECP was significantly associated with decreased IOP after 6- and 12-month periods compared with baseline with MD= 7.26 (95%CI: 4.96, 9.57, p<0.00001), and MD= 8.02 (95CI: 6.15, 9.89, p<0.00001), respectively. Also, TCP was associated with decreased IOP at 6- and 12-month periods with MD= 11.98 (95%CI: 6.17, 17.79, p<0.0001), and MD= 15.41 (95%CI: 9.36, 21.46, p<0.00001), respectively. Both ECP and TCP were also associated with decreased medications at 6-and 12-month measurements.
Conclusion
Conclusion: Both ECP and TCP are effective in the management of glaucoma and in lowering IOP, however, TCP is more effective, and they are equally safe.