Purchase this article with an account.
V Pathak-Ray, R Sengupta, N Saha, AI McNaught, M Austin, JE Morgan; Cyclodiode Ciliary Body Ablation - A Novel Approach To The Treatment Of Aqueous Misdirection Syndrome . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1084.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To report a novel approach to the treatment of aqueous misdirection by cyclodiode ciliary body ablation. Methods: Retrospective analysis of the case notes of eight consecutively presenting patients with aqueous misdirection syndrome. In each case the intraocular pressure and shallowing of the anterior chamber persisted despite intensive medical treatment. Predisposing factors included cataract extraction (five patients), trabeculectomy (four patients) and YAG laser peripheral iridotomy (four patients). Cyclodiode ciliary body ablation was directed at the reduction of ciliolenticular block as well as the direct effects of ciliary body ablation. Laser power was in the range 1.5-3.0 W mean 1.94 SD 0.43, duration 2s, with mean number of burns being 20 (range 9-39). Results: Resolution of aqueous misdirection was achieved in all cases. Mean pre-treatment IOP's were 42.9 mm Hg, SD 17.1 (range 20 to 72). Post laser IOP's were 19.9 mm Hg, SD 13.3 (range 9 to 46). Pre-laser anterior chamber was flat in all cases but reformed following laser treatment. Two patients required further laser treatment to resolve the episode of aqueous misdirection. Two patients subsequently required pars plana vitrectomy to ensure continued reduction in IOP and maintenance of AC depth, surgery taking place 12-14 weeks after cyclodiode laser. Only these latter two patients experienced drop in Snellen visual acuity by two or more lines. Conclusion: Cyclodiode ciliary body ablation is a valuable technique in the management of increased intraocular pressure resulting from aqueous misdirection syndrome. The technique is successful in cases that have not responded to conventional medical treatment though it does not, in every case, eliminate the need for pars plana vitrectomy.
This PDF is available to Subscribers Only