Diode laser transscleral cyclophotocoagulation as a primary surgical treatment for glaucoma-questions and future

Cyclophotocoagulation is one of the efficacious procedures for the treatment of refractory glaucoma.However, its clinical utilization is limited due to severe post-operative complications including phthisis and visual loss.Transscleral cyclophotocoagulation (TCP) is technically simple and less affected by the opening status of the anterior chamber angle.Its effectiveness and complications are mainly related to the energy, spots and scale of the surgery, as well as the ocular pigmentation of the patients.With the advance of technology, both the effectiveness and safety of this procedure gain significant improvement.Meanwhile, it is free from the filtration surgery-related complications due to its noninvasive characteristics.Taken the local economic level, medical resources allocation, as well as the patients’ preference and follow-up into account, utilization of TCP on primary open angle glaucoma (POAG) patients with good vision, or as primary surgical treatment for medically uncontrolled chronic angle closure glaucoma (CACG) and neovascular glaucoma (NVG) were recently tried and showed good preliminary results.It provides new insight in glaucoma therapy, although further evidence from prospective, random control trials are still needed.In present review, both the safety and efficiency, as well as related influent factors of TCP were summarized.The possibility and feasibility of this procedure as a primary surgical treatment for glaucoma were discussed.