Cyclodestructive Procedures for Glaucoma

A cyclodestructive procedure is a type of surgery used to destroy the ciliary body, the part of the eye that produces fluid (aqueous humor). It may be used to treat severe glaucoma that has not improved after other types of treatment or surgery have been tried. Some people need this treatment done more than once.

Laser cyclophotocoagulation

In laser cyclophotocoagulation, a laser beam is used to destroy the ciliary body. For this procedure, medicine to numb the eye is injected behind the eyeball (retrobulbar anesthesia) before the procedure.

For most, but not all, people who have laser cyclophotocoagulation, the pressure in their eyes decreases to their target pressure.

Complications of laser cyclophotocoagulation may include:

• Cloudiness of eyesight.
• Bleeding from the site.
• Inflammation of the area of the eye (uveitis).
• Pain (may be severe).
• Shrinkage of the eyeball (hypotony) due to the decrease in pressure in the eye. This may lead to clouding of the lens (cataract).

Laser cyclodestructive procedures may cause less pain than other cyclodestructive procedures used to destroy the ciliary body.

Cyclocryotherapy

In cyclocryotherapy, an extremely cold instrument (probe) is repeatedly applied to the sclera, the white part of the eye. The probe destroys the ciliary body, the part of the eye that produces fluid.

Usually medicine to numb the eye is injected behind the eyeball before the procedure. After the procedure, the pressure in the eye may briefly rise. The person may have moderate to severe pain after this procedure.

Cyclocryotherapy may be used to treat:

• Glaucoma that results from another condition (secondary glaucoma), such as diabetes.
• Open-angle glaucoma for which conventional or laser surgery has not been successful.
• Congenital glaucoma (uncommon).

Complications of cyclocryotherapy may include:

• A sudden increase in eye pressure.
• Bleeding.
• Shrinkage of the eyeball (hypotony) due to the decrease in pressure in the eye. This may lead to clouding of the lens (cataract).

Because it can cause loss of central vision, which is needed to read and see details clearly, cyclocryotherapy is not usually used for people who have relatively good central vision.