Cyclodestructive procedures. I. Clinical and morphological aspects: a review

Laser cyclophotocoagulation is an accepted method of cyclodestruction, such as cyclocryothermy and the application of cyclodiathermy, microwaves and ultrasound. These procedures may be considered as ultima ratios or 'last-resort interventions'. Also, in cases where surgery is not possible, cyclodestruction may be the initial intervention. Among other lasers, the Nd:YAG and diode lasers are the energy sources of choice. Contact and noncontact methods have about the same clinical efficiency and risk. While immediate complications are transitory, other, late complications, mentioned in the world literature, such as sympathetic ophthalmia, malignant glaucoma and retinal detachment, are more serious but are rare, and their causal relationship with the cyclodestructive procedure is doubtful. However, they still merit our attention. The ultrastructural mechanisms related to cyclocoagulation have been studied. The study of aqueous flow may improve our understanding of cyclophotocoagulation techniques. Cyclophotocoagulation is considered an important cornerstone in glaucoma therapy. The uncertainty of its effect is no greater than that of any other therapeutic measure in the treatment of glaucoma.