Mechanism of Action
Cyclodestructive procedures aim to reduce aqueous production by damaging or destroying the nonpigmented ciliary epithelium. In addition, cyclodestructive procedures (specifically, external approaches) affect the ciliary muscle, which may increase uveoscleral outflow. Laser energy can be applied internally or externally. Internal delivery allows for a more targeted approach with less collateral tissue destruction, but it involves entry into the eye, which introduces a risk of infection and requires the use of an operating room. External delivery can be performed in the office in appropriate patients.
Pantcheva MB, Kahook MY, Schuman JS, Noecker RJ. Comparison of acute structural and histopathological changes in human autopsy eyes after endoscopic cyclophotocoagulation and trans-scleral cyclophotocoagulation. Br J Ophthalmol. 2007;91(2):248–252.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.