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Laser Therapies: Cyclodestructive Procedures

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Surgical Innovations in Glaucoma

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Abstract

Cyclodestructive procedures are usually reserved for cases of glaucoma that are refractory to medical therapy and outflow surgeries and in eyes that have little or no visual potential. Cyclodestruction has been carried out by various methods including surgical excision, diathermy, ultrasound, cryotherapy, and laser. Laser cyclophotocoagulation (CPC) has now become the principle method for surgically reducing aqueous inflow. The delivery of laser energy through the sclera may be performed by either the noncontact or contact method. In the noncontact approach, a slit lamp is employed to apply laser energy through the conjunctival/scleral surface. A contact lens is often applied to keep the eyelids open and blanch the conjunctiva. The focus of energy delivery is 1–1.5 mm behind the limbus and is offset from the aiming beam so that maximal therapeutic effect is at the level of the ciliary body. The potential benefits of the noncontact over the contact approach may include a more precise focus of laser energy on the ciliary body. More recently, contact CPC has gained favor as a preferred method for treating refractory cases of glaucoma.

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, University of California, 0730, 10 Koret Street, San Francisco, CA, 94133-0730, USA

    Toshimitsu Kasuga MD, Guofu Huang MD, PhD & Shan C. Lin MD

  2. Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan

    Toshimitsu Kasuga MD

  3. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China

    Guofu Huang MD, PhD

Authors
  1. Toshimitsu Kasuga MD
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  2. Guofu Huang MD, PhD
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  3. Shan C. Lin MD
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Corresponding author

Correspondence to Shan C. Lin MD .

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Editors and Affiliations

  1. Department of Surgery, Rocky Vista University, Parker, CO, USA

    John R. Samples MD

  2. Western Glaucoma Foundation, Portland, OR, USA

    John R. Samples MD

  3. Cornea Consultants of Colorado, Littleton, CO, USA

    John R. Samples MD

  4. The Eye Clinic, Portland, OR, USA

    John R. Samples MD

  5. Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada

    Iqbal Ike K. Ahmed MD, FRCSC

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Kasuga, T., Huang, G., Lin, S.C. (2014). Laser Therapies: Cyclodestructive Procedures. In: Samples, J.R., Ahmed, I.I.K. (eds) Surgical Innovations in Glaucoma. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8348-9_9

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  • DOI: https://doi.org/10.1007/978-1-4614-8348-9_9

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