Combining ECP With Other MIGS
ECP was the first minimilly invasive glaucoma procedure to be combined with Phacoemulsification for the treatment of uncontrolled open-angle glaucoma in 1995. ECP is affecting the inflow of aqueous production rather than ouflow that is addressed with the newer MIGS devices. As with pharmaceutical treatments, the balancing of the inflow and outflow mechanisms has become the treatment choice for many surgeons. ECP is simple to combine with canal based procedures including iStent, CyPass, Trab 360, GATT, Kahook Blade and Trabectome.
ICE - iStent, Cataract, ECP
ICE (iStent, Cataract Surgery, ECP) has been shown to be safe and more efficatious than Cataract iStent alone. ECP is typically performed following the stent implantation and cataract surgery. In this recent study comparing microbypass stent implantation, cataract extraction and ECP vs stent and cataract extraction alone, the standard Phaco/ECP technique of inflating the ciliary sulcus with viscoelastic prior to inserting the endoscope through the Phaco incision was utilized. 270° of ciliary processes were treated.
ECP is an aqueous inflow reducing procedure. Combing ECP with other outflow procedures offers a balanced surgical solution for the patient that follows the same line of thinking that is used when offering inflow and outflow medications.
"Combining ECP with iStent allows me to tailor glaucoma treatments for my patients."
Nate Radcliffe, M.D.
"I am performing Phaco/ECP/Cypass/Trab360 in patients with severe glaucoma that need a really low IOP."
Steven R. Sarkisian Jr, M.D.
Articles
The Significance of ECP in Today’s Glaucoma Management
Ophthalmolog Management, Volume: 21, Issue: Dec 2017
A pressure-lowering workhorse emerges as potent pairing with MIGS - In the era of minimally invasive glaucoma surgeries (MIGS), it is important to remember that some would say endo-cyclophotocoagulation (ECP) was one of the first MIGS procedures...
SR Sarkisian, Jr., MD; M Welch, DO; E Murphy
Glaucoma Update - MIGS
MIGS and combined procedures will continue to be hot in 2015.
CRST Europe, Nov/Dec 2014
In 2014, ophthalmologists championed further refinements in minimally invasive glaucoma surgery (MIGS) and learned how these procedures can best be applied. Learning where iStent (Glaukos) fits into the surgical management of mild to moderate glaucoma has been a continual process.
Malik Kahook, M.D.
Clinical Studies
Phacoemulsification Combined With Trabecular Microbypass Stent (iStent) and Endolaser Cyclophotocoagulation (ECP).
AGS 2017
Purpose/Relevance: To evaluate the safety and efficacy of the iStent, cataract surgery, ECP procedure (ICE) in patients with glaucoma. Minimally invasive glaucoma surgery (MIDS) is not as effective at controlling intraocular pressure (IOP) as more invasive procedures. I evaluated ICE to see if further IOP control can be obtained.
Coronia, Ronald; Ophthalmic Consultants of Long Island