A Review of Cyclodestructive Procedures for the Treatment of Glaucoma

Anand, Nitin; Klug, Emma; Nirappel, Abraham; Valle, David Solá-Del

doi:10.1080/08820538.2020.1810711

Cited by 31 publications

(35 citation statements)

References 81 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When an even stricter criteria of 50% IOP reduction was applied to our data, the cumulative success rate was 71.6% at POY1, higher than the 59.6% success rate at POY1 achieved by Garcia et al using only MP-TSCPC and a less restrictive IOP reduction criteria of 20% [ 26 ]. It has been well-documented that the IOP-lowering effect of MP-TSCPC appears to wane over time [ 1 ]. For example, while Zarrour et al reported that 86.7% of patients undergoing MP-TSCPC achieved surgical success at 1 month post-treatment (defined as IOP reduction ≥ 20% from baseline), success rates decreased progressively to 67.1% at 6 months and 56.7% in 1 year [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…Currently, two main methods of TSCPC are commonly used: Continuous Wave Transscleral Cyclophotocoagulation (CW-TSCPC) and MicroPulse Transscleral Cyclophotocoagulation (MP-TSCPC). In CW-TSCPC, destructive laser energy is delivered continuously to the ciliary body in an attempt to reduce aqueous humor production, while MP-TSCPC utilizes repetitive pulses of energy separated by periods of rest to achieve more targeted treatment of pigmented tissue in the ciliary processes and minimize collateral damage to neighboring tissues [ 1 ]. While both of these cyclophotocoagulation procedures represent a relatively targeted approach for reducing IOP, dissipated laser energy during administration may cause damage to surrounding tissues [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

“…In CW-TSCPC, destructive laser energy is delivered continuously to the ciliary body in an attempt to reduce aqueous humor production, while MP-TSCPC utilizes repetitive pulses of energy separated by periods of rest to achieve more targeted treatment of pigmented tissue in the ciliary processes and minimize collateral damage to neighboring tissues [ 1 ]. While both of these cyclophotocoagulation procedures represent a relatively targeted approach for reducing IOP, dissipated laser energy during administration may cause damage to surrounding tissues [ 1 ]. The extent of this dissipation may potentially underlie differences in postoperative complications that have been observed between these two procedures [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

“…While both of these cyclophotocoagulation procedures represent a relatively targeted approach for reducing IOP, dissipated laser energy during administration may cause damage to surrounding tissues [ 1 ]. The extent of this dissipation may potentially underlie differences in postoperative complications that have been observed between these two procedures [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Outcomes of a combination of augmented MicroPulse and limited Continuous Wave Cyclophotocoagulation in patients with refractory glaucoma

Gupta

Chang

Chachanidze

et al. 2021

Graefes Arch Clin Exp Ophthalmol

Self Cite

View full text Add to dashboard Cite

Purpose To assess the safety and effectiveness of augmented MicroPulse (MP-TSCPC) with limited Continuous Wave Transscleral Cyclophotocoagulation (CW-TSCPC) in patients with refractory glaucoma. Methods Thirty-eight eyes of 38 patients underwent combined MP-TSCPC and CW-TSCPC at Massachusetts Eye and Ear. Kaplan–Meier survival curves and Wilcoxon paired sign rank tests were performed to evaluate intraocular pressure (IOP), glaucoma medication burden, best corrected visual acuity (BCVA), and adverse events. Results With success defined as IOP reduction ≥ 30% and IOP between 5 and 18 mmHg, the cumulative probability of success at 1 year and 1.5 years were 0.81 (95% confidence interval (CI), 0.68–0.96) and 0.65 (95% CI, 0.50–0.86), respectively. With success defined as IOP reduction ≥ 50% and IOP between 5 and 18 mmHg, the success probability at 1 year and 1.5 years were 0.72 (95% CI, 0.57–0.89) and 0.56 (95% CI, 0.40–0.78), respectively. IOP and medication burden reductions were significant at all follow-up visits compared to baseline. Average IOP decreased from 27.9 mmHg at baseline to 11.4 mmHg at 1 year (p < 0.001) and 10.0 mmHg at 1.5 years (p < 0.001). Average medication burden decreased from 3.8 to 1.7 at 1.5 years (p = 0.001). No significant differences in visual acuity were observed at any time point. No long-term sight-threatening complications due to the combined procedure were observed, and most of the complications observed were mild and transient. Conclusion In patients with refractory glaucoma, the combination of augmented MP-TSCPC with limited CW-TSCPC provides a significant IOP-lowering effect and decrease in medication burden without increased risk of postoperative complications.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Outcomes of a combination of augmented MicroPulse and limited Continuous Wave Cyclophotocoagulation in patients with refractory glaucoma

Gupta

Chang

Chachanidze

et al. 2021

Graefes Arch Clin Exp Ophthalmol

Self Cite

View full text Add to dashboard Cite

show abstract

“…During cyclophotocoagulation, the laser can be delivered through either a transscleral or an endoscopic approach to the ciliary processes and decrease aqueous production. 1,2 In the endoscopic method, the surgeon directly visualizes and targets the ciliary processes using a video camera, while the transscleral method involves transmitting a beam of laser energy to the ciliary body through the overlying sclera. When combined with phacoemulsi cation, laser cyclophotocoagulation can potentially decrease IOP without increasing the surgical risks.…”

Section: Introductionmentioning

confidence: 99%

Transscleral vs Endoscopic Cyclophotocoagulation: Safety and Efficacy When Combined with Phacoemulsification

Nirappel

Klug

Neeson

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

Precis: Phacoemulsification combined with MicroPulse transscleral cyclophotocoagulation appears to provide significantly greater long-term IOP reduction than phacoemulsification combined with endoscopic cyclophotocoagulation without compromising safety.Purpose: To compare the effectiveness and safety of phacoemulsification combined with endoscopic cyclophotocoagulation (phaco/ECP), phacoemulsification combined with MicroPulse transscleral cyclophotocoagulation (phaco/MP-TSCPC), and phacoemulsification alone (phaco) in the treatment of coexisting cataract and glaucoma. Methods: Retrospective cohort study of consecutive cases at Massachusetts Eye & Ear. The main outcome measures were the cumulative probabilities of failure between the phaco/ECP group, phaco/MP-TSCPC group, and the phaco alone group with failure defined as reaching NLP vision at any point postoperatively or the inability to maintain ≥20% IOP reduction from baseline with IOP between 5-18 mmHg. Additional outcome measures included changes in average IOP, number of glaucoma medications, and complication rates. Results: 64 eyes from 64 patients (25 phaco/ ECP, 20 phaco/ MPTSCPC, 19 phaco alone) were included in this study. The groups did not differ in age (mean 71.04 ± 6.7 years) or length of follow-up time. Primary open-angle glaucoma was the most common type of glaucoma in the phaco alone (42%) and phaco/ECP (48%) groups while mixed-mechanism glaucoma was the most common type in the phaco/MP-TSCPC group (40%). The mean IOP reductions at 1 year were 3.07 ± 5.3 mmHg from a baseline of 15.78 ± 4.7 in the phaco/ECP group, 6.0 ± 4.3 mmHg from a baseline of 18.37 ± 4.6 in the phaco/MP-TSCPC group and 1.0 ± 1.6 from a baseline of 14.30 ± 4.2 mmHg in the phaco alone group. Surgical failure was less likely in eyes in the phaco/MP-TSCPC and phaco/ECP groups compared to phaco alone based on the Kaplan-Meier survival criteria, with failure defined as the inability to maintain an IOP reduction of 20% or more with IOP between 5-18 mm Hg long term. There were no differences in complications among the three groups. Conclusions: Phaco/MP-TSCPC appears to provide for greater long-term IOP control than phaco alone and phaco/ECP. All three procedures had similar safety profiles.

show abstract

Angle Closure Glaucoma—Update on Treatment Paradigms

Chansangpetch

Lin

2022

Curr Ophthalmol Rep

View full text Add to dashboard Cite

A Review of Cyclodestructive Procedures for the Treatment of Glaucoma

Cited by 31 publications

References 81 publications

Outcomes of a combination of augmented MicroPulse and limited Continuous Wave Cyclophotocoagulation in patients with refractory glaucoma

Outcomes of a combination of augmented MicroPulse and limited Continuous Wave Cyclophotocoagulation in patients with refractory glaucoma

Transscleral vs Endoscopic Cyclophotocoagulation: Safety and Efficacy When Combined with Phacoemulsification

Angle Closure Glaucoma—Update on Treatment Paradigms

Contact Info

Product

Resources

About