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      Cyclodestructive Procedures

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          Abstract

          Laser cyclophotocoagulation is an accepted method of cyclodestruction, such as cyclocryothermy and the application of cyclodiathermy, microwaves and ultrasound. These procedures may be considered as ultima ratios or ‘last-resort interventions’. Also, in cases where surgery is not possible, cyclodestruction may be the initial intervention. Among other lasers, the Nd:YAG and diode lasers are the energy sources of choice. Contact and noncontact methods have about the same clinical efficiency and risk. While immediate complications are transitory, other, late complications, mentioned in the world literature, such as sympathetic ophthalmia, malignant glaucoma and retinal detachment, are more serious but are rare, and their causal relationship with the cyclodestructive procedure is doubtful. However, they still merit our attention. The ultrastructural mechanisms related to cyclocoagulation have been studied. The study of aqueous flow may improve our understanding of cyclophotocoagulation techniques. Cyclophotocoagulation is considered an important cornerstone in glaucoma therapy. The uncertainty of its effect is no greater than that of any other therapeutic measure in the treatment of glaucoma.

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          Diode laser cyclophotocoagulation: longer term follow up of a standardized treatment protocol.

          M Walland (2000)
          Diode laser cyclophotocoagulation (cyclodiode) is gaining acceptance as a therapy for refractory or end-stage glaucoma. The aim of the study was to establish whether a reproducible dose-effect relationship exists following a single standardized cyclodiode treatment to lower intraocular pressure (IOP).
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            Use of glaucoma drainage devices in the management of glaucoma associated with aniridia.

            Claudia P Arroyave, Ingrid Scott, Steven Gedde … (2003)
            To describe intraocular pressure (IOP) and visual acuity outcomes after glaucoma drainage device placement in eyes with glaucoma associated with aniridia.
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              Transscleral Diode Laser Photocoagulation in Refractory Glaucoma

              Vincenzo Pucci, Giorgio Marchini, Emilio Pedrotti … (2001)
              Background and Objective: Patients with glaucoma refractory to medical or surgical treatment are difficult to treat. The aim of this study was to evaluate the effect of contact transscleral diode laser cyclophotocoagulation (DLPC) on these patients’ intra-ocular pressure (IOP) and visual acuity. Patients and Methods: 37 eyes of 36 patients who suffered from refractory glaucoma and who had undergone DLPC, were followed at the Eye Clinic of Verona University for an average of 14 ± 4 months. The average age was 54 ± 26 years. IOP, visual acuity and ocular complications were analysed. Results: A total of 71 treatments were given. More than 1 treatment was given in 22 eyes (59%). The mean pretreatment IOP was 33.1 ± 3.3 mm Hg. At the last follow-up, the mean IOP was 21 ± 1.6 mm Hg. Mean total medications were reduced from 4.4 ± 0.5 to 2.4 ± 0.3. No serious complications occurred in 71 treatments. Visual acuity remained stable in 25 eyes (67.5%), improved in 6 eyes (16.2%) and decreased in 6 eyes (16.2%). Conclusions: DLPC is effective in lowering IOP in eyes with refractory glaucoma. It also serves to reduce the number of antiglaucoma medications. This procedure is relatively safe. Nevertheless, multiple DLPC applications may be needed.
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                Author and article information

                Journal
                Journal ID (publisher-id): OPH
                Journal ID (nlm-ta): Ophthalmologica
                Journal ID (doi): 10.1159/issn.0030-3755
                Title: Ophthalmologica
                Publisher: S. Karger AG
                ISSN (Print): 0030-3755
                ISSN (Electronic): 1423-0267
                Publication date Subscription-year: 2004
                Publication date (Print): April 2004
                Publication date (Electronic): 04 March 2004
                Volume: 218
                Issue: 2
                Pages: 77-95
                Affiliations
                aLindenhofspital and bInstitute of Anatomy, University of Berne, Berne, Switzerland
                Article
                Publisher ID: 76142 Other ID: Ophthalmologica 2004;218:77–95
                DOI: 10.1159/000076142
                PubMed ID: 15004496
                SO-VID: ec98b05c-c48d-4650-bf90-272d2e75057e
                Copyright © © 2004 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 13 June 2003
                Date accepted : 06 November 2003
                Page count
                Figures: 23, Tables: 4, References: 157, Pages: 19
                Categories
                Subject: Review

                ScienceOpen disciplines: Vision sciences,Ophthalmology & Optometry,Pathology
                Keywords: Laser,Argon laser,Cyclophotocoagulation,Diode laser,Cyclocryothermy,Neodymium:yttrium-aluminum-garnet laser,Last-resort procedure,Glaucoma, malignant
                Data availability:
                ScienceOpen disciplines: Vision sciences, Ophthalmology & Optometry, Pathology
                Keywords: Laser, Argon laser, Cyclophotocoagulation, Diode laser, Cyclocryothermy, Neodymium:yttrium-aluminum-garnet laser, Last-resort procedure, Glaucoma, malignant

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