Introduction  

Cyclodiode laser treatment is a procedure that uses high concentrations of light to control glaucoma. Patients usually seek this treatment after other forms become unsuccessful or are unsuitable. The approach entails the action of destroying a portion of the ciliary body to lower fluid production.

Ciliary bodies in the eye produce aqueous humor essential for waste removal and the provision of nutrients. On ordinary occasions, the fluid flows out through a channel known as the trabecular meshwork. Sometimes hindrance to fluid flow may occur, causing a build-up of intraocular pressure, which may lead to glaucoma. 

In most cases, the cause of blockage is unknown. However, experts sometimes link it to genetic inheritance. Very high intraocular pressure can threaten vision or cause severe pain and discomfort. Although effective, more than one treatment may be necessary.

The procedure rarely improves vision but works to reduce pain, intraocular pressure, and the risk of vision loss.
 

Also Known As

  • Diode laser cyclophotocoagulation
  • Cyclodiode laser therapy

 

Before the Procedure

Before undergoing surgery, it would be vital for patients to understand what the procedure entails. One can achieve this during a brief session with the doctor. Important issues to note include the risks and benefits of the process. The doctor would only proceed with surgery after the patient's consent.

For patients on glaucoma medication, they should continue with the dose as usual unless advised otherwise by the doctor. It is crucial to notify the doctor about any allergic reactions and medical conditions to help minimize risks and side effects.

The operation is usually a one day process, and patients return home on the same day. After surgery, the surgeon may patch the eye or vision may be blurry, and so it would be advisable to organize for a ride home.
 

Types

  • Trans-scleral cyclophotocoagulation
  • Endoscopic cyclophotocoagulation

 

Procedure

The procedure takes place in an operating room and requires a short time to complete. It entails the following steps:

  • The doctor ensures that the patient is comfortably positioned on a bed or in a specially designed chair.
     
  • The ophthalmologist cleans the eye area with a clean cloth then administers drops of local anesthesia to numb the eye.
     
  • Since the patient will remain awake throughout the surgery, they will need to stay still to avoid injuries. The doctor may use general anesthesia, where patients feel anxious.
     
  • For the trans-scleral approach, the doctor places the laser probe on the sclera then moves it around the region transmitting laser energy. While doing this, s/he carefully avoids damaging the long posterior nerves.
     
  • The doctor treats only three-quarter of the eye by making approximately seven applications in each part. The transmission of laser energy continues until there's production of a pop sound.
     
  • The ophthalmologist may make a small cut to insert the endoscopic probe to the space between the iris base and the anterior of the ciliary body. S/he will then navigate to the ciliary body to shrink and whiten it using laser energy.

 

Risks & Complications

The procedure has the risk of inflammation if the doctor does not place the probe properly. One may experience laser burns due to a dry conjunctiva or if the probe is faulty. Bleeding, though rare, may also occur.

Most patients usually experience pain after treatment. Some may also have double vision, but this should subside a few hours after surgery. Another likely side effect is sensitivity to light.

One common complication with the procedure is phthisis bulbi. It is a condition characterized by excessively low fluid production. It may result from overtreatment of the ciliary processes. In extreme cases, one may experience retinal detachment or lose their sight.
 

Aftercare & Recovery

After cyclodiode laser treatment, one may need to implement the following:

  • Continue with glaucoma medication unless the doctor advises otherwise
     
  • Avoid exhausting activities
     
  • Wearing of sunglasses while out in the sun
     
  • Use of steroid drops for a few weeks to reduce inflammation
     
  • Use of over the counter pain relievers
     
  • Minimal touching and rubbing of the eye
     
  • Follow up visits as scheduled by the doctor. The first visit is usually the next day
     

One may take approximately six weeks to recover from the effects of laser treatment fully.
 

Outcome

Cyclodiode laser treatment rarely restores sight, and therefore, patients should not expect an improvement in vision. 

The expected outcome would be a reduction in intraocular pressure and pain. However, the results of the surgery will vary among patients. The difference may be because of:

  • Age
     
  • The type of glaucoma
     
  • An instance of previous glaucoma surgery
     
  • Presence of other conditions such as diabetes

Patients may undergo more than one treatment, and the success rate usually increases with the next treatment.