1. Simultaneous Cataract and ECP Glaucoma Surgery An opportunity to improve your vision while reducing or completely eliminating your dependence on Glaucoma medications.

2. ECP Endoscopic Cyclophotocoagulation A surgical procedure that effectively inhibits the production of aqueous fluid in the eye, typically resulting in a decrease in intraocular pressure, and a reduction or elimination of a patient’s dependence on glaucoma medications.

3. ECP Endoscopic Cyclophotocoagulation While there are other simultaneous surgical options to treat cataract patients with elevated intraocular pressure, ECP offers the best safety record, most predictably improved outcomes, least complicated follow up, and quickest recovery of any.

4. The ECP procedure is performed using a state-of-the-art Laser MicroEndoscope. About the diameter of a paper clip, it is one of the smallest medical endoscopes developed to date. ECP

5. Endoscopes Have Revolutionized Minimally Invasive Surgery Endoscopes are used in many applications:. Arthoscopy: The examination of joints, (i.e. knee, shoulder), for diagnosis and treatment (arthroscopic surgery). Bronchoscopy: examination of the trachea and lung's bronchial trees to reveal abscesses, bronchitis, carcinoma, tumors, tuberculosis, alveolitis, infection, inflammation. Laparoscopy: visualization of the stomach, liver and other abdominal organs including the female reproductive organs, for example, the fallopian tubes.

6. A Laser MicroEndoscope utilizes an integrated imaging and laser fiberoptic bundle to provide simultaneous viewing, and highly targeted treatment, of intraocular structures that generally could not otherwise be seen or treated.

7. Laser MicroEndoscope Tip Video Imaging FiberCoaxial LightingLaser Fiber

8. The Laser MicroEndoscope affords surgeons unprecedented views of intraocular structures

9. During Simultaneous Cataract & ECP Glaucoma Surgery the Laser MicroEndoscope is introduced through a small incision already made during the cataract procedure. Side View Showing cornea, iris, ciliary body and lens.

10. The Laser MicroEndoscope is placed under the Iris allowing the Surgeon to view and direct controlled laser energy to the surface cells of the ciliary processes. Side View Showing cornea, iris, ciliary body and lens.

11. The cilary processes are a series of organs located below the base of the underside of the iris, which exude aqueous fluid into the eye. Side View Showing cornea, iris, ciliary body and lens.

12. The surface cells of the Ciliary Processes absorb the laser energy, shrinking them and inhibiting production of aqueous fluid. Bottom View Showing an Intraocular Lens, the iris, and the ciliary body. Laser Endoscope introduced. Ciliary process is treated.

13. This video shows the Ciliary Processes being treated. As they absorb laser energy they visibly whiten and shrink. Martin Uram, MD Narrates Live Surgery

14. ECP Glaucoma Surgery at the same time as Cataract Surgery can typically be done in 5 to 8 minutes. The combined procedures are performed under local anesthesia on an out patent basis.

15. CLINICAL OUTCOMES OVERVIEW ECP has been performed in the United States since early 1990’s. The technique and technology has evolved significantly over that term, and ECP has established a record of unparalleled safety and effectiveness in the treatment of Primary Open Angle Glaucoma, particularly when performed with Cataract Surgery.

16. CLINICAL OUTCOMES OVERVIEW Clinical Studies on ECP around the globe have confirmed that: 50% - 55% of ECP patients are able to discontinue Glaucoma Medications post operatively. 75% - 80% of ECP Patients are able to reduce number and/or frequency of Glaucoma Medications. Over 90% of ECP Patients experience a reduction in IOP averaging around 25%.

17. Eyes Treated in Study = 1008 Simultaneous Cataract & ECP Surgery on 506 eyes Cataract Surgery alone on 502 eyes Decrease in Glaucoma Medications Simultaneous Cataract & ECP Surgery - 80.0% Cataract Surgery alone - 14.0% Elimination of all Glaucoma Medications Simultaneous Cataract & ECP Surgery - 54.0% Cataract Surgery alone - 9.4% Procedure Comparison Overview Cataract Surgery vs. Simultaneous Cataract & ECP MacKool ECP Study Group* Richard MacKool, MD; Ophthalmology Management, 2003

18. ECP Warrants Consideration Safe Convenient Effective ECP is a proven safe and effective procedure to reduce Intraocular pressure, particularly when performed in conjunction with Cataract Surgery. Most ECP Patients may reduce or eliminate dependence on Glaucoma Medications - Improved Compliance with Dosage Instructions - Potential Reduction in Risk of Drug Interactions - Potential Reduced of Costs of Ongoing Medications Most ECP Patients experience a clinically significant long term reduction in Intraocular pressure.

19. Simultaneous Cataract and ECP Glaucoma Surgery For More Information or to schedule an appointment to evaluate your candidacy for ECP Surgery, please contact: Pam Morgan Patient Services Director Tel: (618) 545-6700 Email: pmorgan@bluerouteeye.com