Endoscopic diode laser cyclophotocoagulation with a limbal approach.

BACKGROUND AND OBJECTIVE

Endoscopic diode laser cyclophotocoagulation with a limbal approach was reviewed retrospectively. The delivery system and procedure used as well as the role of this procedure in the management of glaucoma are discussed.

PATIENTS AND METHODS

An 810-nm pulsed continuous-wave diode laser capable of 1.2-W output was used. The maximum treatment area is 7 to 8 clock hours with a single limbal incision. Generally, 800 mW were used for less than 1 second, for a total of 0.8 J per treatment.

RESULTS

Eight eyes of 6 patients were treated. The mean follow-up time for each procedure was 3.2 months (range 1 to 8 months) and for each eye was 5.1 months (range 2 to 8 months). Pre- and postoperative intraocular pressures were determined. Postoperative inflammation was the most common complication.

CONCLUSION

One reason for the failure of transscleral cyclophotocoagulation, particularly in congenital glaucoma, may be displacement of the ciliary processes. This displacement does not permit the indirect treatment to reach the appropriate area. Because endoscopic laser cyclophotocoagulation allows direct visualization, treatment can be accurately applied to individual ciliary processes.