ThermoCyclo for last resort treatment
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.
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.
Always use the appropriately rated safety eyewear when operating a laser.
Glaucoma treatment: Thermocyclo procedure
Thermocyclo is indicated in the following:
Where patients may have experienced
ThermoCyclo is contraindicated
Local anaesthetic is necessary; retrobulbar or peribulbar injection, or sub tenon anaesthesia with 2% mepivacaine or equivalent.
Excess treatment power may result in ocular surface burns or ciliary body hemorrhage. The maximum possible laser power for this device is 2500 mW.
A lid speculum may be used to maintain appropriate access to the palpebral fissure. Apply methylcellulose to the eye every four shots, ensuring the laser probe always remains in moist contact with the sclera.
Use transscleral illumination to locate the ciliary body (approximately 2.5 – 3.5 mm from the limbus). The laser delivery is transscleral. Care should be taken to avoid areas of scleral thinning or where there is heavy pigmentation at the perilimbal conjunctiva.
Laser settings selection and adjustments are the responsibility of the clinician, for each patient.
General power settings are 1250 mW for 4000 milliseconds for darkly pigmented irises and 1500 mW for 3500 milliseconds for lighter iris colors.
The laser probe should be held parallel to the visual axis and perpendicular to the iris plane and a series of 5 – 7 laser spots applied per quadrant with a minimum of one full spot space between each pulse.
Typically, three quadrants will be attempted, avoiding 3 & 9 o’clock positions as well as the temporal quadrant region.
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Talk about ThermoCyclo Laser therapy