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O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | D E C E M B E R 2 0 1 4
Around the bend
Endoscopic cyclophotocoagulation (ECP) also involves laser energy,
but instead of using it to clear the drain, this approach seeks to turn
off the tap. A fiber-optic laser endoscope is inserted through a small
single incision to cauterize and partially destroy the ciliary process tis-
sue that rings the back side of the iris. This treatment temporarily
halts the ciliary bodies' production of aqueous humor as a way of con-
trolling increased IOP.
A video probe incorporated into the endoscope allows the physician
to directly visualize the anatomy during the treatment. "We're operat-
ing in the eye while looking at a screen," says Dr. Olander.
ECP "is a finer procedure" than the transcleral approach to
cyclophotocoagulation, he says, "which had a bad reputation for
hypotony (low IOP)
and other complica-
tions." It can also be
conveniently added
on to minimally inva-
sive cataract surgery,
using the same inci-
sion created for the
phaco tip.
"It's another 30 to
60 seconds added on
to the end of the pro-
cedure," says Dr.
Newsom. "You may
have to increase the
number of post-op
drops you give the
O P H T H A L M O L O G Y
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