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Surgical Management of Inflammatory Eye Disease pp 193–200Cite as

Cyclodestructive Procedures

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Abstract

■ The main advantages of transscleral cyclodestructive procedures compared to other glaucoma surgical procedures are (a) ease of performance and (b) possibility of retreatments.

■ Both transscleral cyclocryocoagulation and cyclophotocoagulation using either Nd:YAG or diode laser are characterized by (a) a comparable success rate and (b) no linear dosage–efficacy relationship.

■ Because transscleral cyclophotocoagulation acts more selectively (by melanin absorption) than cyclocryocoagulation, (a) postoperative inflammatory reaction is less intense and (b) the risk of further scleral damage, such as scleral atrophy from scleritis, is lower.

■ There is a strong age-dependent probability of success for all cyclodestructive procedures, which is independent of the underlying type of glaucoma.

■ Transscleral cyclophotocoagulation has not only a lower risk profile, but also a lower success rate than other surgical procedures in pediatric glaucoma, including secondary glaucoma in pediatric uveitis. It remains a surgical procedure of last choice in children.

■ Transscleral cyclophotocoagulation offers a good therapeutic opportunity in older patients with uveitic glaucoma after other glaucoma surgery has failed. Probably it has the best benefit–risk ratio in scleritis-associated glaucoma if parameters of application are reduced.

■ Endoscopic cyclophotocoagulation is an intraocular procedure, which allows more precise diode laser application under direct visualization of the ciliary processes. Whereas the results in refractory glaucoma are encouraging, success rate is much lower in pediatric glaucoma. More experience is needed with this treatment modality concerning inflammatory glaucoma.

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Author information

Authors and Affiliations

  1. Clinic Ambimed, Klingenstrasse 9, 4057, Basel, Switzerland

    Torsten Schlote

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  1. Torsten Schlote
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Editors and Affiliations

  1. Universitäts-Augenklinik Heidelberg, Interdisziplinäres Uveitiszentrum, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany

    Matthias Becker

  2. Dept. of Ophthalmology, Triemli Hospital Zürich, Birmensdorfer Straße 497, 8063, Zürich, Switzerland

    Matthias Becker

  3. Ophthalmology, Univ. of Miami Bascom Palmer, 900 NW 17th Street, 33136, Miami, FL, FL, USA

    Janet Davis

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© 2008 Springer-Verlag Berlin Heidelberg

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Schlote, T. (2008). Cyclodestructive Procedures. In: Becker, M., Davis, J. (eds) Surgical Management of Inflammatory Eye Disease. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-33862-8_17

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  • DOI: https://doi.org/10.1007/978-3-540-33862-8_17

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-33861-1

  • Online ISBN: 978-3-540-33862-8

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