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TRANSSCLERAL CYCLOPHOTOCOAGULATION
Hoshimov Ulug’bek Abduvahob o’g’li
Ophthalmologist, laser-microsurgeon at the Bukhara branch of the scientific and
practical Medical Center of specialized eye microsurgery of the Republic Uzbekistan
https://doi.org/10.5281/zenodo.13638113
Traditionally, surgeons have reserved transscleral cyclophotocoagulation for instances of
superior glaucoma in which maximal medical therapy is insufficient to manage the IOP.
Appropriate candidates for the process encompass patients in whom a couple of filtering
surgeries have failed, these deemed to be at high danger for complications after or the failure
of filtering surgical treatment (eg, people with aphakic glaucoma, neovascular glaucoma, or
glaucoma after penetrating keratoplasty), and sufferers with low visible doable for whom an
invasive manner is not reasonable.
1
Patients have to be recommended of the possible risks and advantages related with
transscleral cyclophotocoagulation. We start by means of detailing the need for and dangers of
retrobulbar anaesthesia, together with pain, bleeding, infection, harm to the retro-orbital
vessels and optic nerve, bruising, and periorbital swelling.
2
We typically perform transscleral
cyclophotocoagulation in the medical institution besides the benefit of monitored anaesthesia
care. Without suitable discussion, the experience of a retrobulbar injection may also be fairly
annoying for patients. They need to be cautioned that extra injections may also be required in
the course of the process to augment anaesthesia and have to be urged at once to alert the
physician to any pain they experience.
3
It is hard to interpret outcome measures after transscleral cyclophotocoagulation due to
differences in affected person populations and definitions of success as nicely as the lack of a
ample variety of subjects in prospective, randomized studies. Bloom and colleagues performed
a retrospective assessment of 210 eyes present process preliminary or repeat (18%)
cycloablation with cyclophotocoagulation.
4
The preoperative diagnoses included neovascular
glaucoma, disturbing glaucoma, aphakia, and silicone-oilÐinduced glaucoma. Decreases in
imaginative and prescient were noted in 28% of dealt with sufferers and have been more
common in these with neovascular glaucoma and silicone-induced glaucoma. Graft failure came
about in 9.5% of patients with preexisting penetrating keratoplasties.
Transscleral diode cyclophotocoagulation is an superb surgical process for glaucoma that
is refractory to maximal scientific remedy and/or previous penetrating surgery. Proper
affected person determination and surgical technique help to limit the procedure's
acknowledged aspect results and improve its long-term success. Treating physicians should be
acquainted with the nuances of the laser machine and G-probe, and they need to continue to be
vigilant for problems all through both the peri- and postoperative periods. Future devices may
also include direct real-time imaging skills that ought to enhance each the protection and
efficacy of noninvasive cycloablative procedures.
1
Malik Y. Transscleral Cyclophotocoagulation. University of Pittsburgh. 2007.
2
Kahook M. Penetrating cyclodiathermy for filtration. Arch Ophthalmol. 1970;83:47-48.
3
Robert J. Cryosurgery for the treatment of glaucoma. Trans Am Ophthalmol Soc. 1964;63:189-204.
4
Noecker M. Panretinal xenonphotocoagulation combined with cyclocryotherapy in the treatment of severe
glaucoma. Acta Ophthalmol (Copenh). 1989;67:652-656.
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References:
1.
Malik Y. Transscleral Cyclophotocoagulation. University of Pittsburgh. 2007.
2.
Kahook M. Penetrating cyclodiathermy for filtration. Arch Ophthalmol. 1970;83:47-48.
3.
Robert J. Cryosurgery for the treatment of glaucoma. Trans Am Ophthalmol Soc.
1964;63:189-204.
4.
Noecker M. Panretinal xenonphotocoagulation combined with cyclocryotherapy in the
treatment of severe glaucoma. Acta Ophthalmol (Copenh). 1989;67:652-656.
