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What Is Laser Cyclophotocoagulation?

Laser cyclophotocoagulation is a glaucoma procedure that uses laser energy to treat the ciliary body, the part of the eye that produces aqueous humor. By reducing fluid production, it lowers intraocular pressure (IOP) to help protect the optic nerve. It is often used when glaucoma is difficult to control with drops or other treatments, or when medication burden needs to be reduced. Different techniques exist, including transscleral and endoscopic approaches.

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What Is Laser Cyclophotocoagulation?

Laser cyclophotocoagulation is a glaucoma procedure that uses laser energy to treat the ciliary body, the part of the eye that produces aqueous humor. By reducing fluid production, it lowers intraocular pressure (IOP) to help protect the optic nerve. It is often used when glaucoma is difficult to control with drops or other treatments, or when medication burden needs to be reduced. Different techniques exist, including transscleral and endoscopic approaches.

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Why Laser Cyclophotocoagulation Is Used

Doctors use cyclophotocoagulation to lower eye pressure when glaucoma remains uncontrolled or when other options are not suitable. It can also be used to relieve symptoms in eyes with very high pressure. The goal is pressure reduction, which may slow glaucoma damage.

  • Refractory glaucoma with persistently elevated IOP
  • Need to reduce glaucoma medication load when appropriate
  • Painful high-pressure eye when comfort is a priority

Types of Cyclophotocoagulation

Technique choice depends on the eye's anatomy, glaucoma type, and surgeon preference. Transscleral cyclophotocoagulation (TSCPC) delivers laser through the white of the eye. Endoscopic cyclophotocoagulation (ECP) treats the ciliary processes from inside the eye, often combined with cataract surgery. Micropulse TSCPC delivers energy in short pulses with rest periods, which is intended to limit collateral heat damage in some patients.

  • Continuous-wave diode TSCPC
  • Micropulse transscleral cyclophotocoagulation
  • Endoscopic cyclophotocoagulation

What to Expect and Recovery

Most treatments are outpatient and use numbing drops, and sometimes light sedation. You may have soreness, redness, and blurry vision for a few days while inflammation settles. Anti-inflammatory drops are commonly prescribed, and glaucoma drops may be adjusted based on pressure checks. Follow-up visits are important because IOP can change in the first days to weeks after treatment.

  1. Pre and post-laser pressure checks and drops as directed
  2. Laser delivery with a probe outside the eye or an endoscope inside the eye
  3. Short-term follow-up to monitor inflammation and IOP response

Risks and Limitations

Possible risks include inflammation, temporary IOP spikes, and pain that may require medication. Over-treatment can cause hypotony, meaning abnormally low eye pressure, which can harm vision. Rare complications include bleeding, vision loss, or severe shrinkage of the eye in advanced cases. Results vary, and some patients need repeat treatment or additional glaucoma surgery to reach target pressure.

  • Short-term pressure spike and anterior inflammation
  • Hypotony or persistent low IOP in some eyes
  • Variable durability of pressure lowering over time

FAQs on Laser Cyclophotocoagulation

Does laser cyclophotocoagulation cure glaucoma?

No. It is a pressure-lowering treatment that helps reduce the risk of ongoing optic nerve damage, but it does not reverse existing glaucoma damage. Many patients still need monitoring and sometimes ongoing medications or additional procedures.

How is micropulse different from traditional TSCPC?

Micropulse TSCPC delivers laser energy in short on and off cycles to allow tissue cooling between pulses. Traditional continuous-wave TSCPC delivers continuous energy that can create more thermal injury. Your surgeon selects the method based on goals and risk profile.

What is the difference between ECP and transscleral treatment?

ECP treats the ciliary processes from inside the eye using an endoscope and is often done during cataract surgery. Transscleral treatment delivers energy through the sclera without entering the eye. Both aim to lower IOP, but their workflow, visibility, and risk considerations differ.

When should I call my doctor after the procedure?

Call urgently for severe or worsening pain, marked redness, sudden drop in vision, nausea with eye pain, or any rapid change in symptoms. Mild irritation and blur can be expected early, but symptoms should improve rather than worsen.

References

Micropulse Transscleral Cyclophotocoagulation. EyeWiki. https://eyewiki.org/Micropulse_Transscleral_Cyclophotocoagulation. Date Accessed February 9, 2026.

Slow-Coagulation Continuous-Wave Transscleral Cyclophotocoagulation Laser for Treatment of Glaucoma. EyeWiki. https://eyewiki.org/Slow_Coagulation_Continuous_Wave_Transscleral_Cyclophotocoagulation_Laser_for_Treatment_of_Glaucoma. Date Accessed February 9, 2026.

Cyclodiode Laser Glaucoma Therapy. StatPearls (NCBI Bookshelf, National Institutes of Health). https://www.ncbi.nlm.nih.gov/books/NBK578176/. Date Accessed February 9, 2026.

Cyclophotocoagulation in Glaucoma: A Systematic Review of Techniques and Outcomes. PubMed Central (National Library of Medicine). https://pmc.ncbi.nlm.nih.gov/articles/PMC11087674/. Date Accessed February 9, 2026.

Cyclodiode vs Micropulse Transscleral Laser Treatment in Refractory Glaucoma. Eye (Nature). https://www.nature.com/articles/s41433-024-03253-7. Date Accessed February 9, 2026.