- The patient stays at our Hospital for about 1-2 hours.
- Obviously the surgery itself takes less time. The patient does not feel pain, as the surgery is performed under the so-called combined anesthesia. This means that the anesthesiologist administers intravenous sedatives and painkillers, while the ophthalmologist anesthetizes the eye topically.
Endoscopic cyclophotocoagulation (ECP) is the latest development in the management of glaucoma. It gives hope to patients in whom other treatment methods have failed. The procedure is also recommended for patients in whom the risk of complications from other methods of glaucoma management is too high (such as those suffering from Sturge-Weber syndrome).
A major advantage of ECP is that the surgery can be performed simultaneously with another procedure, such as cataract surgery.
As with other glaucoma procedures, ECP is all about lowering the intraocular pressure. Excessively high intraocular pressure which persists over a long period of time can significantly affect the visual acuity and result in its permanent deterioration, and even cause a complete loss of vision.
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Before the ECP procedure it is necessary to undergo a pre-assessment at the Retina Ophthalmological Outpatient Clinic and Hospital. All necessary diagnostic tests will be performed in order to determine how advanced the glaucoma is.
What does ECP involve?
The goal of the ECP procedure is to reduce the amount of aqueous humor in the eye. Using an endoscope, the doctor treats the ciliary body with a laser, which has the effect of reducing the secretion of the aqueous humor, and the pressure in the eye is reduced.
Characteristics of the ECP treatment
1. High efficacy
After an ECP surgery in about 90% of patients intraocular pressure is reduced by 30% on average. Pressure reduction can be observed already on the day of the surgery. Admittedly, the damage done by glaucoma cannot be undone, but by controlling intraocular pressure we stop or significantly slow down the progression of the disease.
The successful outcome of the procedure makes it also possible to reduce or eliminate glaucoma medications.
However, it should be remembered that various factors have an impact on the success of the procedure, e.g. the age of the patient, the type of glaucoma, the structure of the eye, other eye surgeries (including glaucoma surgeries), as well as chronic diseases (diabetes, hypertension, etc.).
The ECP procedure is a minimally invasive surgery and it is safe. It has been documented by numerous studies carried out during 20 years of using this method.
3. Possibility of combining the ECP procedure with other glaucoma treatments
Should it happen that, despite the ECP procedure, the decrease in the intraocular pressure is insufficient, the doctor may use additional pharmacological or surgical methods.
4. Possibility to apply in any form of glaucoma
Thanks to its precision, ECP can be used at any stage of glaucomatous optic neuropathy.
Indications for the ECP procedure
- When glaucoma cannot be controlled pharmacologically.
- When glaucoma is stabilized, but the patient wants to eliminate pharmacological treatment (this is especially important due to the increasing frequency of drug intolerance).
- The procedure can be performed in conjunction with cataract surgery or shortly after.
- on the day of the surgery, you should report to the Clinic wearing comfortable clothes (e,g. a tracksuit); you will be given a disposable patient bodysuit
- on the day of the surgery do not put on facial or eye makeup,
- prescribed chronic-use medications should be taken at the usual time, except the ones listed below,
- 3-7 days before the surgery patients should discontinue blood thinners, such as: Acard, Aspiryna, Aspro C, Asprocol, Polopiryna, Rhonal, Ring N, Solucytel, Thomapyrin, Pradaxa, Xarelto, Plavix, Warfin, Acenokumarol.
Prior to the scheduled surgery you will be provided with additional detailed information
What to expect during the ECP surgery
Important after a glaucoma surgery
After the procedure the patient should not use public transport, and should be escorted home by an adult companion.
For 24 hours after anesthesia the patient cannot drive, operate dangerous equipment or drink alcohol.
After the surgery the face should not be immersed in water and the eye should be kept dry, as this can lead to infection. For 3 weeks caution should be exercised when bathing, until the wound becomes watertight.
For 2-3 weeks after the surgery patients should abstain from doing work that requires a lot of physical effort (e,g., moving heavy furniture or lifting over 15 kilograms).
On sunny days patients should wear sunglasses.
The dressing remains on the patient’s eye until the first follow-up visit, which takes place the day after the procedure. Then next follow-up visits are scheduled.
Ophthalmic drops should be used according to the regime specified in the treatment information sheet.
Any discomfort should subside after a few days up to 2 weeks after the surgery.