Update on ciliary body laser procedures.

PURPOSE OF REVIEW: There are currently various options available for glaucoma treatment procedures ranging from laser to penetrating to nonpenetrating surgeries. Innovations in glaucoma surgical therapeutics include features such as external application, focused tissue effects, and minimal manipulation as these factors all help lower the risk of side-effects in addition to increasing the success rate of the treatment. Traditional diode laser transscleral cyclophotocoagulation (TSCPC) is invasive and destructive. This review aims to provide an overview of the latest ciliary body laser modalities, including micropulse diode laser transscleral cyclophotocoagulation (MP-TSCPC), as well as endoscopic cyclophotocoagulation.

RECENT FINDINGS: MP-TSCPC and endoscopic cyclophotocoagulation, less invasive interventional procedures than filtering surgeries, have shown promise in having reduced postoperative complications while demonstrating reasonably good success rates. These modalities allow direct effects to the inflow system of the eye. The precision of these interventions has led to comparable or greater control of intraocular pressure (IOP) and lower inflammatory-fibrotic response in comparison to conventional TSCPC. Recent studies of these procedures have focused on their repeatability, long-term survival rate, and ability to be combined with cataract surgery.

SUMMARY: The development of new minimally invasive surgical modalities such as MP-TSCPC and endoscopic cyclophotocoagulation has provided new options for treating glaucoma with a relatively safe side-effects profile as compared with filtration surgeries. These new treatments can lead to a significant decline in the number of postsurgical medications needed for IOP control.