Endoscopic Cyclophotocoagulation

Background

Glaucoma is an eye disease in which the pressure inside the eye is too high. Over time this elevation in eye pressure causes damage to the optic nerve and, in severe cases, may result in blindness. Eye pressure can be lowered by several techniques including eye drops, office based laser treatment, or surgery.

Endoscopic Cyclophotocoagulation (ECP), a surgical laser, is used to coagulate or destroy the ciliary processes. The ciliary processes produce fluid which circulates through the eye. By reducing their number, eye pressure should be lower.

Evidence

ECP has been used to treat many different forms of glaucoma. Studies show that successful intraocular pressure control is achieved in 90% of treated eyes. Compared to other therapies, ECP exhibits a high safety profile and appears to be the safest glaucoma surgical option available.

Procedure

ECP is a surgical procedure performed in a hospital setting or surgery center. Under local anesthesia, a fiberoptic viewing system and laser probe are used to visualize the ciliary processes, followed by treating them with laser. The procedure is brief.

ECP may be performed as a stand-alone procedure, or combined with other eye surgery (cataract or retinal procedure).

Risks

Temporary inflammation is common following ECP. Due to the invasive nature of all surgical procedures, infection or hemorrhage may occur, but are rare.

Alternatives

Treatments for glaucoma include eye drops, office based laser treatment, or surgery center based procedures designed to facilitate fluid flow out of the eye.

Comment

Glaucoma is a serious ocular condition which may lead to blindness. ECP is a procedure to lower eye pressure, diminish or eliminate the need for glaucoma eye drops, and save vision. For patients with glaucoma who are anticipating eye surgery (cataract extraction, epiretinal membrane removal, etc.). ECP may be an appealing addition.