Transcleral CycloPhotoCoagulation for glaucoma treatment

Abraham Bruck · medicine forum beginner Joined: 19 Apr 2006 Posts: 2

I would like to have some idea about:
1. What is the frequency of CPC procedures in various parts of the world?
2. If there would be an efficient way to accurately guide the laser to the
ciliary body, and to follow up the cyclophotocoagulation in real time, would
that increase the frequency of that process?
Abraham Bruck

plpfoot@gmail.com · medicine forum beginner Joined: 18 Mar 2006 Posts: 14

In the U.S. transcleral cyclophotocoagulation is a treatment of last
resort; it is by definition destructive, is somewhat unpredictable, and
is very difficult to titrate. It is better than cyclocryotherapy but
is not my idea of a good time. The laser is aimed by just knowing
where the ciliary body is in relation to the limbus.

A less accepted but growing procedure in endocyclophotocoagulation
which is done from the inside of the eye and directly targets the
ciliary processes; the cells that produce aqueous. It does not have
the dramatic effect of transcleral but is also far less dangerous. It
is usually done in combination with cataract surgery.

I do not know what you mean by follow up the cyclophotocoagulation in
real time. It takes weeks to really tell what the effect will be.

Ted

Abraham Bruck · medicine forum beginner Joined: 19 Apr 2006 Posts: 2

Ted.
Thanks
By real time follow up I mean that by using ultrasound imaging and
optoacousticaly, (ultrasound generated by the laser itself), generated
ultrasound it will be possible to aim the laser to the right point, actually
see the exact target of the laser beam as well as coagulation progress.
Would such a technique, if proved to be reliable, reduce the reluctance to
use cyclophotocoagulation? or there are other reasons for using it as the
last resort?
Abraham

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plpfoot@gmail.com · medicine forum beginner Joined: 18 Mar 2006 Posts: 14

Since it has to pass through the entire ciliary body it is still very
destructive. It is only the ciliary processes that produce aqueous and
this procedure destroys more than those cells. I would not expect your
nifty aiming procedure to increase its use at all.

Ted.

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