Transscleral cyclophotocoagulation in the treatment of glaucoma: patient selection and perspectives

Rebecca Liebenthal, Joel S. Schuman

Research output: Contribution to journalReview articlepeer-review

Abstract

Introduction Cyclodestructive procedures involve destroying part of the ciliary epithelium to reduce production of aqueous humor and lower intraocular pressure (IOP). Due to its complication rate, cycloablation was historically reserved for eyes with refractory glaucoma that have failed previous filtration procedures, have poor vision and IOP control despite maximal medical therapy, and for relief of pain in blind eyes. Areas covered In this review paper, we cover different forms of transscleral cyclophotocoagulation (TCPC), their degrees of success, and their complication rates. Contact diode laser transscleral cyclophotocoagulation is currently a commonly used method. Micropulse diode laser transscleral cyclophotocoagulation is a newer paradigm that has shown promising results. We also review the outcomes of TCPC in eyes with different subtypes of glaucoma and ocular history. As the modalities improve, TCPC may be safer than previously assumed, and the indications for TCPC may be expanded. Expert opinion In general, TCPC is an effective and relatively safe way to treat patients with glaucoma. More comparative studies are required to determine if TCPC should be used at earlier stages of disease.

Original languageEnglish (US)
Pages (from-to)357-375
Number of pages19
JournalExpert Review of Ophthalmology
Volume16
Issue number5
DOIs
StatePublished - 2021

Keywords

  • Glaucoma
  • Nd:YAG laser
  • Neovascular glaucoma
  • cyclodestruction
  • diode laser
  • micropulse transscleral cyclophotocoagulation
  • primary open-angle glaucoma
  • pseudoexfoliation glaucoma
  • transscleral cyclophotocoagulation

ASJC Scopus subject areas

  • Biomedical Engineering
  • Ophthalmology
  • Optometry

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