What is ThermoCyclo?

Also referred to as Transscleral Cyclophotocoagulation (TSCPC), Thermocyclo is a destructive laser technique for treatment of advanced uncontrollable or refractory glaucoma. 

The ciliary processes and ciliary body are targeted with a continuous wave of 810 nanometer laser energy for a duration long enough to thermally denature tissue, resulting in the reduction of aqueous humor production, resulting in a decrease of Intra Ocular Pressure (IOP). 

An audible sound of the ciliary process bursting may sometimes be heard during this procedure.

Thermocyclo with probe

Technology

The treatment is performed with the Vitra 810 laser from Quantel Medical using Thermocyclo treatment settings and the SubCyclo® laser probe with footplate attached.

The footplate ensures the correct probe angle for laser delivery, parallel to the visual axis and perpendicular to the iris plane.

Treatment guidelines

Always use the appropriately rated safety eyewear when operating a laser. 

Glaucoma treatment: Thermocyclo procedure

Thermocyclo is indicated in the following:
  • Aphakic Glaucoma
  • Neovascular Glaucoma
  • Uveitis Glaucoma
  • Refractory Pediatric Glaucoma
  • Glaucoma after intravitreal silicone oil
Where patients may have experienced
  • Previous failed filtration surgery with poor prognosis for retreatment
  • post-penetrating keratoplasty or scleral buckling
  • Combined with poor visual potential

  • And/Or
  • Require pain relief
  • Are unsuitable for filtration surgery
  • Have not responded effectively to pharmacological treatment
  • Have not responded effectively to other laser therapies such as SubCyclo photocoagulation, peripheral iridotomy and/or SLT
ThermoCyclo is contraindicated
  • For albino patients
  • Eyes with a total occlusion of aqueous outflow
Anaesthetic
Local anaesthetic is necessary; retrobulbar or peribulbar injection, or sub tenon anaesthesia with 2% mepivacaine or equivalent.
Warning
Excess treatment power may result in ocular surface burns or ciliary body hemorrhage. The maximum possible laser power for this device is 2500 mW.

Clinical data

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.

Physicians

Talk about ThermoCyclo Laser therapy

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Clinical References

Les références