Cyclophotocoagulation (CPC)
Cyclophotocoagulation (CPC)
Author: Aashna Bhakkad
Purpose: A laser procedure used to lower intraocular pressure (IOP) in glaucoma by reducing fluid production in the eye.
When CPC is Recommended
- Advanced or refractory glaucoma
- Neovascular glaucoma
- Painful blind eyes
- Plateau iris syndrome
- Patients not suitable for traditional surgery
May be used earlier in treatment due to newer, gentler techniques (e.g., Micropulse CPC, ECP)
Procedure:
- Patient is prepped and given local anesthesia with optional twilight sedation
- Eyelids are held open with a speculum
- A laser probe is positioned:
- Transscleral/Micropulse: Applied to the surface of the white of the eye
- ECP: Inserted into the eye via a small incision (usually during cataract surgery)
- Transscleral/Micropulse: Applied to the surface of the white of the eye
- The 810-nm laser targets the ciliary body, shrinking tissue to reduce aqueous fluid production
- Laser is applied in a controlled pattern around the eye, usually covering 180–270° of the ciliary processes
- Laser energy is titrated based on tissue response (lower energy for micropulse, direct visualization for ECP)
- The probe is removed
- Eye is cleaned and may be patched temporarily
- Patient is given post-op drops (steroids, antibiotics) and instructions for follow-up
Laser Type: 810-nm diode laser
Access:
Transscleral CPC: Laser applied externally to the white of the eye
Micropulse CPC (MP-CPC): Laser delivered in short bursts to minimize tissue damage
Endocyclophotocoagulation (ECP): Probe with a camera inserted inside the eye for direct laser application (often combined with cataract surgery)
Goal: Shrink ciliary body processes to reduce aqueous humor production
Repeatability: May be repeated if tissue regenerates or pressure rises again
What to Expect After the Procedure
Recovery Timeline:
Effects develop over 2–6 weeks
Common Symptoms:
Mild eye soreness
Tearing or burning
Temporary blurry vision
Light sensitivity
Medications:
Steroid and antibiotic eye drops (prescribed)
Post-Op Care:
Avoid: rubbing eyes, heavy lifting, swimming, eye makeup
Wear: sunglasses during the day, protective shield while sleeping
Follow-Up Visits:
Day after procedure
1 week post-op
Additional visits as needed
Results & Risks
Expected IOP Reduction:
20–30% on average
Benefits:
May reduce or eliminate some glaucoma medications
Slows progression of glaucoma
Risks (Rare):
Inflammation
Hypotony (low eye pressure)
Vision loss
Bleeding
Sympathetic ophthalmia
Side Effects:
Temporary discomfort or irritation
Temporary blurred vision
Citations:
Authors, Dean McGee. “Laser Cyclophotocoagulation for Glaucoma in Oklahoma City.” DMEI | Dean McGee Eye Institute, 24 May 2024, www.dmei.org/services-specialties/glaucoma/treatment-options/laser-treatments/laser-cyclophotocoagulation/.
Authors, WillsEye Hospital. “Cyclophotocoagulation (CPC).” Wills Eye Hospital, 13 Jan. 2020, www.willseye.org/cyclophotocoagulation-cpc/.
Cohen, Amir, et al. “Endoscopic Cyclophotocoagulation for the Treatment of Glaucoma.” Survey of Ophthalmology, vol. 62, no. 3, 2017, pp. 357–365, pubmed.ncbi.nlm.nih.gov/27717892/, https://doi.org/10.1016/j.survophthal.2016.09.004.
Emanuel, Matthew. “Diode Cyclophotocoagulation (CPC).” Glaucoma Associates of Texas, 14 June 2022, www.glaucomaassociates.com/laser-treatment-for-glaucoma/diode-cyclophotocoagulation-cpc/.
Ou, Yvonne. “Glaucoma Surgery Series: Cyclophotocoagulation.” BrightFocus Foundation, 24 Aug. 2021, www.brightfocus.org/resource/glaucoma-surgery-series-cyclophotocoagulation/.
Pastor, S. “Cyclophotocoagulation a Report by the American Academy of Ophthalmology.” Ophthalmology, vol. 108, no. 11, Nov. 2001, pp. 2130–2138, https://doi.org/10.1016/s0161-6420(01)00889-2.
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