Diode laser cyclophotocoagulation for intraocular pressure control
Overview
Transscleral diode cyclophotocoagulation (TSCP) and micropulse transscleral cyclophotocoagulation (MP-TSCP) are treatment choices to reduce intraocular pressure (IOP) for a variety of glaucoma. These lasers target and destroy the pigmented epithelium of the ciliary body, thereby decreasing aqueous humor production. Traditional TSCP delivers intensive laser energy at a continuous dose and often causes collateral tissue damage and significant inflammatory reaction. On the other hand, MP-TSCP emits a sequence of repeated, brief energy pulses that alternate with rest intervals, which may lessen collateral tissue injury by allowing for a "cooling period" and heat dissipation between bursts. TSCP is exclusively used in refractory cases with poor visual potential, whereas MP-TSCP can also be used in subjects with good vision and early-staged glaucoma.
Features Summary
Glaucoma is one of the leading causes of irreversible blindness worldwide. Intraocular pressure is a well-documented risk factor for the development and progression of glaucoma. Pressure-lowering therapy is the only effective treatment for halting the progression of glaucomatous change. When IOP is difficult to manage with medications or even surgical interventions, diode laser cyclophotocoagulation may be required to preserve the remaining optic nerve function or alleviate pain caused by intractable high IOP.
Procedure
The treatment usually takes place in the outpatient setting or the operating theatre. The physician will inject the local anesthetic around the eye before the laser. In TSCP, the physician holds a pen-like laser probe firmly against the side of the limbus and delivers the laser energy one spot after another circumferentially. In MP-TSCP, a similar laser probe is also placed on the side of the eye and goes back and forth in a “painting” fashion. The treatment itself takes approximately 10 to 20 minutes to complete. After the procedure, the doctor will prescribe eye drops to decrease inflammation in the eye.
Notification
The eye may become red and painful following laser treatment. Anti-inflammatory eye drops are necessary because of the inflammation following the laser. In MP-TSCP, the postoperative discomfort is usually much milder than that after traditional TSCP.
Occasionally, the pressure can be over-reduced by the laser. Repeating the procedure is an option if the pressure decrease is insufficient or if it gradually increases again. Rarely, the laser may result in irreversible visual loss.
After the laser treatment, you will receive a scheduled appointment and return to the clinic to evaluate the laser effect on IOP.
Estimated Cost
For estimated medical costs, please contact International Medical Services Center.