Cyclophotocoagulation with an illuminated laser probe under a noncontact wide-angle retinoscope: A modified technique of ciliary body photocoagulation

Qian, Yi; Cai, Bin; Huang, Jiehong; Chen, Lishuang; Yin, Hong; Bai, Zhi-Sha

doi:10.4103/ijo.ijo_65_18

Cited by 2 publications

(2 citation statements)

References 28 publications

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“…It is a more invasive technique requiring the opening of the eyeball to introduce an optical fibre which brings laser energy into contact with the CP. Ab‐interno CP ablation was initially performed by applying argon laser using an endophotocoagulation probe after vitrectomy and lensectomy and allows directly visualizing the CP by scleral depression (Fleischman et al 1981; Patel et al 1986; Zarbin et al 1988; Yi et al 2019). The greatest difficulty with this therapy is that the CP is hardly visualized in vivo except under these unique circumstances.…”

Section: Cw‐tscpc and Ecpmentioning

confidence: 99%

An update on continuous‐wave cyclophotocoagulation (CW‐CPC) and micropulse transscleral laser treatment (MP‐TLT) for adult and paediatric refractory glaucoma

Souissi¹,

Mer²,

Metge³

et al. 2020

Acta Ophthalmologica

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Purpose Continuous‐wave cyclophotocoagulation (CW‐CPC) is often preferred to medical and surgical treatments for managing refractory glaucoma. This review summarizes diode CW‐CPC indications, history, histopathology, methods, efficacy and safety. It also provides an overview of the latest data available on micropulse transscleral laser treatment (MP‐TLT) that uses repetitive micropulses of diode laser energy in an off‐and‐on cyclical fashion. Methods A literature review was conducted on transscleral CW‐CPC (CW‐TSCPC), endoscopic CPC (ECP) and MP‐TLT. Relevant series of adult and paediatric patients were included for assessing the procedures. Results Regarding CW‐TCPC, highly variable success rates are reported in the literature, depending on the definition of success, type of underlying glaucoma, energy settings, follow‐up duration and retreatment rates. CW‐CPC often needs to be repeated, especially in paediatric patients. CW‐CPC exposes to risks of inflammation and chronic ocular hypotony or phthisis with irreversible visual loss. CW‐TSCPC has mainly been used in very severe forms of glaucoma, in painful eyes with limited visual potential or after filtering surgery failure. Published data on ECP are more limited but overall good success rates have been reported. Through the direct visualization of the targeted ciliary body in anatomically abnormal eyes, ECP is the preferred surgical procedure in paediatric refractory glaucoma. Complication rates are relatively low after ECP; however, large studies with long‐term follow‐up are needed. ECP may be used in difficult, refractory cases, but it is often used earlier when combined with cataract surgery. Despite limited data on the exact mechanism of action of MP‐TLT and a lack of standardization of laser settings, the first data from heterogeneous case series shows that it has a similar efficacy and a better safety profile compared to CW‐TSCPC in the medium term. Conclusion Although they may lead to sight‐threatening complications, both CW‐TSCPC and ECP seem effective. ECP appears to be superior to CW‐TSCPC in paediatric refractory glaucoma. Unlike ECP combined with cataract surgery, evidence supporting a wider use of CW‐TSCPC and MP‐TLT in earlier stages of neuropathy is lacking. While it now appears that the safety profile of MP‐TLT is superior to that of CW‐CPC, robust prospective comparative studies including homogeneous and well‐defined cohorts of patients are still needed to confirm an at least comparable efficacy in the long term.

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Section: Cw‐tscpc and Ecpmentioning

confidence: 99%

An update on continuous‐wave cyclophotocoagulation (CW‐CPC) and micropulse transscleral laser treatment (MP‐TLT) for adult and paediatric refractory glaucoma

Souissi¹,

Mer²,

Metge³

et al. 2020

Acta Ophthalmologica

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“…Several modalities of CPC are used, including transscleral cyclophotocoagulation (TS-CPC), endoscopic cyclophotocoagulation (ECP), and micropulse CPC 9 . Endoscopic cyclophotocoagulation is an ab interno procedure that requires an incision and is mainly used in glaucoma following cataract surgery (GFCS) 10 …”

mentioning

confidence: 99%

Continuous Wave Transscleral Cyclophotocoagulation and Endoscopic Cyclophotocoagulation in Childhood Glaucoma: A Meta-Analysis

Elhusseiny,

Hassan,

Elsaman

et al. 2024

Journal of Glaucoma

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Purpose: To report the outcomes of continuous wave-transscleral cyclophotocoagulation (TS-CPC) and endoscopic cyclophotocoagulation (ECP) in childhood glaucoma. Methods: We performed a systematic search of relevant databases. We collected data on age, follow-up duration, type of glaucoma, previous surgical interventions, preoperative and postoperative intraocular pressure (IOP), preoperative and postoperative number of glaucoma medications, adverse events, number of sessions, and success rates at different time points. The main outcome measures are the amount of IOP and glaucoma medication reduction. Results: We included 17 studies studying 526 patients (658 eyes); 11 evaluated the effectiveness of TS-CPC (268 patients, 337 eyes), 5 evaluated ECP (159 patients, 197 eyes), and one study compared both techniques (56 patients, 72 eyes for TS-CPC vs. 43 patients, 52 eyes for ECP). The median duration of follow-up was 28 months in the TS-CPC group and 34.4 months in the ECP group. The mean number of treatment sessions was 1.7 in the TS-CPC and 1.3 in the ECP. In the TS-CPC group, the mean IOP was significantly reduced from 31.2±8 to 20.8±8 mmHg at the last follow-up (P<0.001). The mean number of glaucoma medications was reduced from 2.3±1.3 to 2.2±1.3 (P=0.37). In the ECP group, there was also a significant reduction in the mean IOP from 32.9±8 mmHg with a mean of 1.7±0.7 glaucoma medications to 22.6±9.8 mmHg (P<0.0001) on 1.2±1.1 medications (P=0.009) at the last follow-up. Conclusion: Both TS-CPC and ECP were effective in reducing the IOP and glaucoma medications in childhood glaucoma. Multiple treatment sessions were required.

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Cyclophotocoagulation with an illuminated laser probe under a noncontact wide-angle retinoscope: A modified technique of ciliary body photocoagulation

Cited by 2 publications

References 28 publications

An update on continuous‐wave cyclophotocoagulation (CW‐CPC) and micropulse transscleral laser treatment (MP‐TLT) for adult and paediatric refractory glaucoma

An update on continuous‐wave cyclophotocoagulation (CW‐CPC) and micropulse transscleral laser treatment (MP‐TLT) for adult and paediatric refractory glaucoma

Continuous Wave Transscleral Cyclophotocoagulation and Endoscopic Cyclophotocoagulation in Childhood Glaucoma: A Meta-Analysis

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