What is cyclophotocoagulation surgery for glaucoma?

Laura C. Fine, MD
When other methods of glaucoma control fail, a group of procedures collectively called cyclodestructive surgery may be useful. These surgeries share the common goal of treating the ciliary body in order to decrease fluid production. Cyclodestructive surgeries were first done with diathermy (electric cautery) or cryotherapy (freezing), but now lasers are also used. In this laser procedure, also called cyclophotocoagulation, the surgeon applies a probe, usually on the surface of the eye, and then uses a laser to treat the secreting cells of the ciliary body. The overall success rate in controlling intraocular pressure is 60% to 80%, and the risk of serious complications is relatively low. But many patients require more than a single treatment. The reason this therapy is not used sooner in glaucoma management is that even if pressure control is achieved, cyclodestructive surgery may cause inflammation that can interfere with vision and possibly produce cataract.
Cyclophotocoagulation surgery is used most often in advanced or severe cases of glaucoma. This procedure uses the laser beam to destroy parts of the ciliary body that produce the aqueous humor fluid. With less fluid flowing through the eye, the intraocular pressure is reduced. A local anesthetic is used to numb the eye.

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