Enhancing safety of transscleral diode cyclophotocoagulation: Check the tip before use

Area of Science:

• Ophthalmology
• Glaucoma Treatment
• Laser Surgery

Background:

• Severe glaucoma requires advanced treatment options when conventional methods fail.
• Transscleral Diode Laser Cyclophotocoagulation (TDLC) is an established procedure for refractory glaucoma.
• Potential complications, though rare, necessitate careful procedural review.

Observation:

• A 56-year-old male patient developed an unexpected scleral burn during TDLC.
• The burn was directly attributed to pigment accumulation on the laser probe tip.
• This complication occurred despite the patient undergoing TDLC for severe, treatment-resistant glaucoma.

Findings:

• The scleral burn demonstrated remarkable spontaneous healing capabilities.
• Topical treatment alone was sufficient for complete resolution of the burn.
• No further surgical intervention was required for the burn complication.

Implications:

• Highlights the critical need for meticulous inspection of laser probe tips during TDLC.
• Underscores the importance of managing potential pigment sources to prevent intraoperative complications.
• Suggests that scleral tissue possesses significant regenerative potential following thermal injury.
• Emphasizes the value of vigilant monitoring and conservative management in ophthalmic laser procedures.