New Modalities of Cycloablation and High-Intensity-Focused Ultrasound

Abstract

Cycloablative or cyclodestructive procedures aim to lower intraocular pressure (IOP) by decreasing the function of the ciliary body and thereby decreasing the rate of aqueous production. Cycloablative procedures were typically used in refractory glaucoma in eyes with poor visual potential; however, more focused energy and targeted destruction of the ciliary body have led to an increase in cyclodestructive treatment options that are now an important adjunct to our surgical armamentarium. This chapter highlights the history of these procedures while focusing on current modalities including transscleral diode cyclophotocoagulation (TSCPC), micropulse transscleral diode cyclophotocoagulation (MP-TSCPC, MicroPulse P3, IRIDEX IQ810 Laser System, Mountain View, CA, USA), and High-Intensity Focused Ultrasound (HIFU). Specifically, this chapter discusses the protocols, indications, results, and complications of each featured procedure.