“Cyclophotocoagulation in Glaucoma”
Transscleral cyclophotocoagulation of the ciliary body is an effective technique to reduce intraocular pressure in case of glaucoma. Due to concerns over complications, the main indications for this second-line treatment are refractory glaucoma medication / surgery and low visual prognosis. The 2000 milliwatts (mW) for 2 seconds settings are used by the majority of researchers and clinicians according to the published literature. Some have proposed using 1250 mW for 4 seconds to improve the use of this medical procedure. The aim of this study is to determine how different parameters affect the efficacy of the treatment. This is a prospective double-blinded randomized controlled trial comparing two groups, the experimental group using 1250 mW for 4 seconds and the control group using 2000 mW for 2 seconds.
Procedure - Cyclophotocoagulation protocol
Intravenous route is installed Retrobulbar anaesthesia : 50% xylocaine (2%) + 50% bupivicaine Parameters set for laser treatment (1250mW-4seconds or 2000mW-2 seconds depending on the assigned group) Pars plana measurement using transillumination (if needed) Laser treatment applied approximately 1mm post to limbus Dexamethasone 0,5 mg subconjunctival injection Post-op regimen: Prednisolone 1% qid x 4 weeks, Atropine 1% bid x 2 weeks + Erythromycin ointment + patch x 6h
Procedure - Conventional cyclophotocoagulation
1250 mW for 4 seconds.
Procedure - Modified cyclophotocoagulation
2000 mW for 2 seconds.
Modified Settings for Transscleral Cyclophotocoagulation of the Ciliary Body in Glaucoma : A Randomized Controlled Trial