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Decision to use cycloablative procedures rests with clinician
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AMSTERDAM — The most common way to target and ablate ciliary processes of the ciliary body is by way of the trans-scleral route using laser through the scleral bed, according to a speaker.
Typical patients who undergo cycloablative procedures are not only patients with glaucoma refractory to medical and surgical therapy, but also patients with painful blind eye, Pavi Agrawal, MD, MSBC, FRCOphth, said at Glaucoma Subspecialty Day preceding the European Society of Cataract and Refractive Surgeons meeting.
Furthermore, other patients who may be candidates for cyclophotoablation are patients with refractory glaucoma with good visual acuity, patients who are unsuitable for filtration surgery – for example, a patient who should not undergo general anesthesia – and patients in underdeveloped countries where follow-up may be infrequent.
“You can use diode in any form of glaucoma. It’s a clinical decision that you need to make based on the information given to you,” Agrawal said.
Endocyclophotocoagulation is a newer procedure than trans-scleral cyclophotocoagulation that uses less energy and yields better complication rates, Agrawal said.
“The beauty of [ECP] is that you can directly visualize the ciliary body,” Agrawal said of the intraocular technique.
Disclosure: Agrawal has no relevant financial disclosures.