Take-home message: A proprietary glaucoma device has changed current thinking about cyclophotocoagulation by offering another option in the glaucoma treatment algorithm and allowing earlier laser intervention when medical treatment comes up short.
Fairfield, CT—The typical glaucoma treatment algorithm progresses from medical therapy to laser procedures and then to traditional surgical procedures.
Laser procedures can be used to either increase aqueous outflow, such as with laser trabeculoplasty, or decrease aqueous production, such as with cycloablative procedures.
Just as argon laser trabeculoplasty has largely been replaced by selective laser trabeculoplasty, with lower levels of laser energy and fewer side effects, transscleral cyclophotocoagulation (TCP) is also getting a makeover.
Cyclophotocoagulation was traditionally relegated to cases of refractory glaucoma with poor visual potential due to the risks associated with the procedure.1,2
However, it has started to gain traction as a modality for glaucoma cases with good vision potential following refinements to the procedure, such as the use of an 810-nm laser and a transscleral approach. In a study evaluating the long-term results of TCP in eyes with ambulatory vision (6/36 or better), results showed a mean reduction of IOP of 43% and mean visual acuity preserved in the subgroups with good vision.3
Overall complication rate in this study was 9%, including hyphema, chronic iritis, and corneal edema.