¿Qué es ThermoCyclo?

Además de ser conocida como ciclofotocoagulación transescleral láser, o TSCPC, ThermoCyclo es una técnica láser destructiva para el manejo del glaucoma avanzado incontrolable o resistente al tratamiento. Los procesos ciliares y el cuerpo ciliar reciben una onda continua de 810 nanómetros de energía láser durante el tiempo suficiente como para desnaturalizar el tejido térmicamente, lo que da lugar a la reducción de la producción de humor acuoso y, en consecuencia, a una menor presión intraocular (PIO).
Durante esta técnica, a veces es posible oír un sonido por el estallido de los procesos ciliares.
Termociclo con sonda

Tecnología

El tratamiento se realiza con el láser Vitra 810 de Quantel Medical utilizando los ajustes de tratamiento ThermoCyclo y la sonda láser SubCyclo® con la base colocada. La base garantiza un ángulo de sonda correcto para la emisión láser, en paralelo al eje visual y en perpendicular al plano del iris.
graphique-thermocyclo-1

Directrices de tratamiento

Al manipular un láser, utilice siempre gafas de seguridad con un nivel de protección adecuado.

Tratamiento del glaucoma: procedimento thermocyclo

ThermoCyclo es indicado para:
  • Glaucoma afáquico
  • Glaucoma neovascular
  • Glaucoma uveítico
  • Glaucoma infantil resistente al tratamiento
  • Glaucoma por el uso de aceite de silicona en inyecciones intravítreas
Cuando los pacientes:
  • Se hayan sometido previamente a una cirugía de filtración infructuosa con un mal pronóstico de retratamiento
  • Se hayan sometido a una queratoplastia penetrante o un cerclaje escleral
  • En combinación con un mal potencial visual

Y/o
  • Requieren analgésicos
  • No son aptos para cirugía de filtración
  • No han respondido bien al tratamiento farmacológico
  • No han respondido bien a otros tratamientos láser, como fotocoagulación SubCyclo, iridotomía periférica y/o SLT.
  • ThermoCyclo está contraindicado:
    • En pacientes albinos
    • En ojos con obstrucción total del flujo de salida acuoso
    Anestesia
    Se requiere anestesia local; inyección retrobulbar o peribulbar, o anestesia subtenoniana con mepivacaína al 2 % o equivalente.
    Advertencia
    El exceso de energía del tratamiento puede ocasionar quemaduras en la superficie ocular o hemorragia en el cuerpo ciliar. La potencia láser máxima de este equipo es 2500 mW.

    Datos clinicos

    Titre

    Texte

    The role of Selective Laser Trabeculoplasty as a primary and secondary treatment

    04/03/2022
    Glaucoma is the most common optic neuropathy. The only clinically proven treatment is to reduce IOP by using medical, laser, and surgical therapies. Treatment is typically selected depending on the level of IOP, stage of the disease, pace of progression, and current and past treatment history. Glaucoma management with drops can be problematic, mainly because they can be difficult for patients to instill properly and because of the related side effects.

    Selective Laser Trabeculoplasty: A Safe and Effective First-line Therapy for Glaucoma

    09/06/2021
    In treating glaucoma, the typical route is often to prescribe medications. If topical drops fail to achieve a reduction in intraocular pressure (IOP), then the alternative is to try laser trabeculoplasty, and finally surgery.

    Let There Be (Laser) Light

    09/05/2021
    From 2019 to 2020, I co-chaired the European Glaucoma Society (EGS) Guidelines Committee with Carlo Traverso. The 5th Edition of the EGS guidelines was published in October 2020, after a superb team effort among a large number of colleagues (1). We aimed to promote evidence-based clinical practice and, to that end, followed GRADE methodology, including identification of key questions, critical evaluation of published literature, and formulation of recommendations.

    Ranking Laser in Glaucoma Treatment

    09/02/2021
    Glaucoma management has traditionally taken a stepped approach based on the level of risk involved. The low-risk treatment option is medication. Next are laser/selective laser trabeculoplasty (SLT), MIGS, and incisional surgery. It ends with the highest risk option of cyclodestructive procedures.

    Terminology and Guidelines for Glaucoma

    18/11/2020
    Download the EGS Guidelines on the European Glaucoma Society website.

    Visual Field Outcomes from the Multicenter, Randomized Controlled Laser in Glaucoma and Ocular Hypertension Trial (LiGHT)

    18/10/2020
    To compare visual field outcomes of ocular hypertensive and glaucoma patients treated first with medical therapy with those treated first with selective laser trabeculoplasty (SLT).

    SLT earns a place as first-line therapy

    09/03/2020
    Glaucoma specialists have traditionally viewed topical therapy as first-line treatment for glaucoma. Recently, however, this paradigm has been challenged. Selective laser trabeculoplasty (SLT), though FDA approved since 2001, has gained acceptance as first-line treatment over the last 5 to 10 years.

    Selective Laser Trabeculoplasty Updates and Tips

    09/09/2018
    The glaucoma surgical landscape is bombarded with a variety of new microinvasive glaucoma surgery (MIGS) procedures daily. These new procedures are altering the paradigm and treatment concepts of glaucoma surgery and are accelerating the importance of earlier surgical intervention aimed at reducing morbidity of progression, reducing the need for more aggressive surgical options (while preserving those options), and reducing the burden of medication along with patientcompliance issues, which is one of the most prevalent problems in glaucoma treatment today.

    Selective Trabeculoplasty in the Management of Open Angle Glaucoma: Retrospective Analysis at 1 Year

    09/12/2017
    In order to prevent the progressive and irreversible loss of optic nerve fibres, the treatment of glaucoma aims to effectively and lastingly reduce Intraocular Pressure (IOP) in affected patients. To this end, in addition to medical and surgical techniques, means of weakening the trabeculum by laser have been developed since the 1980s, following the pilot study by Wise and Witter.

    Médicos

    Hable sobre la terapia ThermoCycloLaser

    Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.
    No data was found

    Referencias clínicas

    Les références