3.7 years ago

anonymous FitEyes member ♦ 1.1k

@member_31

Can anyone comment on Endocyclophotocoagulation (ECP)? Has anyone had ECP done to them (or a family member)? How long has it been around? What is the long term success rate? Is it controversial?

3.7 years ago

david 4.3k

@david_fe

Today a FitEyes member followed up on ECP:

I had the Endocyclophotocoagulation laser surgery a year ago. My doctor said it probably will not work. (I am not sure why he wanted to do this procedure when he didn't expect it to work.) Insurance did pay for it. I think it was around $8000 which was good that I didn't have to pay.

I also think I lost eye vision with the ECP procedure. I myself would not recommend this procedure to anyone. This is my opinion but everyone's eyes are different so all of us have different outcomes.

NOTE: If ECP is recommended to you, please instead look into the micropulse version of ECP, which is called MP-TSCPC: What is Micropulse transscleral cyclophotocoagulation for glaucoma? | Ask FitEyes

3.7 years ago

david 4.3k

@david_fe

A FitEyes member shared this experience in 2009:

I recently had ECP done in conjunction with a cataract removal in my left eye. This was recommended as an option but not a mandate.

Here is some background on my eye pressure before the ECP procedure:

Typical Eye pressure without drops: Left: 24
Right: 26

Typical Eye pressure with Xalatan drops (for most of 2007, 2008 and 2009):
Left: 18 to 21 Right: 19 to 21

Last visit before ECP surgery - with Xalatan applied to both eyes Left: 22 Right: 22

Day after ECP surgery on left eye only:
Left: 16 Right: 19 The right eye is lower due to temporary use of an oral pill to keep pressure low.

7 days post Left: 18 - Xalatan no longer used Right: 21 - Xalatan continued in right eye only

I estimate a 6 point reduction in IOP in left eye due to ECP.

Early indication is that ECP could be more effective than drops. The total outcome success of ECP is four to six weeks Post Op.

I was not guarenteed results of ECP. From what I have read it can reduce or eliminate drops but success rate is not as well documented as well as I would have liked to see prior to making the decision.

NOTE: the above is from 2009. In 2021 and beyond, you need to know about the micropulse version of ECP, which is called MP-TSCPC: What is Micropulse transscleral cyclophotocoagulation for glaucoma? | Ask FitEyes

3.7 years ago

david 4.3k

@david_fe

A FitEyes member shared this experience in 2012:

I have had cataract surgery on both eyes last year. My glaucoma specialist performed the cataract surgery and did it primarily to lower my eye pressure (IOP). I have very narrow angles and my IOP was as high as 45 mmHg.

At the same time he did the cataract surgery, he also did endocyclophotocoagulation (ECP).

My surgery was very very successful. My pressures came down to between 17 and 20 in each eye, which for me personally are great numbers. I went from 4 different eye drops down to just two: timolol and azopt.

I was very nervous and resistant to all other types of surgeries he suggested. My doctor is glad now that i waited to do the least invasive surgery. It is now routinely used in his office for the glaucoma patients that he feels will benefit from it.

NOTE: the above is from 2012. In 2021 and beyond, you need to know about the micropulse version of ECP, which is called MP-TSCPC: What is Micropulse transscleral cyclophotocoagulation for glaucoma? | Ask FitEyes

3.7 years ago

david 4.3k

@david_fe

In 2016, Dr. Nathan Radcliffe was using ECP. For one FitEyes member in 2016, he recommended the following:

As for which surgery, my recommendation would be for a glaucoma drainage device, cataract extraction and a laser procedure called Endocyclophotocoagulation (ECP). That would give you the best chance of a well controlled pressure for life.

It is true I mentioned less invasive options, microstents and lasers, but with less invasive approach comes reduced chance of success in your case. We can discuss further in my office.

NOTE: the above is from 2016. In 2021 and beyond, you need to know about the micropulse version of ECP, which is called MP-TSCPC: What is Micropulse transscleral cyclophotocoagulation for glaucoma? | Ask FitEyes

3.7 years ago

david 4.3k

@david_fe

In 2016, Dr. David Richardson was also using ECP. Today he would most likely recommend the micropulse version of ECP, which is called MP-TSCPC. (Of course, that is determined by a consultation between him and the patient.) Please see this link for his recent comments on MP-TSCPC: What is Micropulse transscleral cyclophotocoagulation for glaucoma? | Ask FitEyes

In 2016, Dr. David Richardson shared the following comments on ECP (and other options):

Ab-interno canaloplasty is an exciting variation of canaloplasty with great potential. It could be the first Minimally Invasive Glaucoma Surgery (MIGS) that actually works. Quick disclosure: I'm not impressed with the results of the other MIGS procedures currently available in the USA: trabectome, endocyclophotocoagulation, and iStent.

Early results of Ab-interno Canaloplasty (or ABiC) are promising but there are no long-term results available yet as this variation of the procedure is only about a year old (as of 2016).

In 2016, he said: the latest presented-but-not-yet-published data are:

After undergoing ABiC, 32 patients were at the 6 months post op stage and had an average IOP reduction of 38% (a drop of 8.5mmHg) down to 13.3 on 1 medication.

Pretty impressive, but it is a small study with limited follow-up.

I have not, to date, performed ABiC. Why? Because those who travel to see me (and a large percentage of my patients needing glaucoma surgery travel from significant, if not great, distances) expect to have Ab-Externo Canaloplasty due to it's established and impressive track record both in safety and IOP lowering effect. I would, however, consider it in someone who was on anticoagulation (blood thinners) who could not safely be taken off of them as Ab-Externo Canaloplasty is exceedingly challenging (and not always possible) in those who are actively anticoagulated.

Warm regards, David Richardson, MD

3.7 years ago

david 4.3k

@david_fe

In the summer of 2019 a FitEyes member said:

This summer I had cataract surgery done to open up narrowing angles (my lenses were clear). I am not sure whether the correct IOL was placed in my left eye as the vision has never been the same. I feel like I am looking through a white film, and wonder if increased magnification will make any difference. I had a Kahook Dual Blade Goniotomy and Endocyclophotocoagulation done simultaneously. I am wondering if the endocyclophotocoagulation (ECP) is the culprit? I have since had A YAG procedure done and it had no affect.

In Spring 2021 the same FitEyes member followed up:

I had ECP done two years ago along with a Kahook Dual Blade Goniotomy, and IOL replacement to open up narrow channels. I have permanent vision loss in one eye, and am suspicious of the ECP causing it.