Cyclophotocoagulation is a form of eye surgery designed to help people who suffer with glaucoma. It is only used in extreme cases and in most situations doctors will not resort to the surgery until other treatment options have been exhausted. The outpatient procedure is performed with a laser under local anesthetic. It works well for most patients and even if there are some risks associated, most consider it worthwhile because of its effectiveness.
Glaucoma is a disease caused by an overactive fluid production inside the eye. When this gets out of control, it leads to pressure and intense pain, along with vision loss. Cyclophotocoagulation surgery is targeted directly at the problem. A laser is used to damage the ciliary body, which is a gland inside the eye responsible for manufacturing fluid. Once the damage is done, the ciliary body is diminished and it becomes less efficient in its production of liquid, which leads to a reduction of pressure and typically less pain for the patient.
Endoscopic cyclophotocoagulation (ECP) is a version of the surgery where the ophthalmologist uses a tiny fiber optic camera to help guide the laser. The cameras used in this procedure are less than 1 mm in diameter. They greatly reduce the risks by increasing the surgeon's accuracy, so that the ciliary body is the only thing damaged. ECP was developed during the 1990s and over time, it has proven to be reliable and effective.
When recovering from cyclophotocoagulation, a patient may find that his or her eyes are tender for a couple of weeks. The doctor typically will prescribe pain medication to help a patient cope. Some patients have long-term problems due to the surgery, such as permanent vision impairment. The general feeling among physicians is that since glaucoma itself can cause blindness, the risks are worth taking when other treatments fail.
Laser cyclophotocoagulation, however, does not always last forever — the ciliary body can recover from the damage done during the surgery. When this happens, the gland will begin producing more fluid, gradually increasing pressure, and resulting in the need for additional surgery. In this sense, cyclophotocoagulation is not a cure for glaucoma but more a method of controlling the disease. Once the surgery is complete, the patient will sometimes be able to drop his or her glaucoma medication completely, and nearly all patients are able to reduce their dosage significantly.