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A. Tandon, M.G. Parker, C.A. Bruno, V.M. Elner; Histopathology of Endoscopic Cyclophotocoagulation (ECP) . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5469.
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Endoscopic cyclophotocoagulation (ECP) was first described utilizing a diode laser by Uram in 1990. ECP decreases intraocular pressure by photocoagulating the secretory epithelium of the pars plicata of the ciliary body, thereby decreasing aqueous humor production. ECP use has increased due to the ease of application, efficacy of intraocular pressure control, and minimal side effects. We report a 78–year–old man who underwent ECP in 2003 for uncontrolled primary open–angle glaucoma. The eye was later enucleated in 2005, after becoming blind and painful. We report, to our knowledge, the first histopathologic description of ECP.
Case report with histopathologic analysis.
Histopathology of the eye confirmed the diagnosis of end–stage open–angle glaucoma. The ciliary body demonstrated ablation of the pigmented and non–pigmented epithelium of the ciliary body pars plicata, sparing the pars plana. The effect of ablation was also seen in the smooth muscle of the pars plicata which demonstrated areas of inner smooth muscle replaced by fibrosis. A focus of chronic non–granulomatous inflammation affected the muscular portion of the pars plicata.
ECP effectively and selectively ablates the epithelium of the pars plicata with limited extension into the smooth muscle of the pars plicata. The presence of inflammation demonstrates the potential of this procedure to induce post–surgical inflammation. Thus, ECP should be used with the understanding that sympathetic ophthalmia can potentially occur, similar to other ophthalmic surgical procedures.
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