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Cyclophotocoagulation and Trabectome for Glaucoma

Dr. David Richardson, one of the country's leading ophthalmologists, discusses Cyclophotocoagulation and Trabectome for Glaucoma. Part 5 of 12 of "What's New In Glaucoma Surgery", a Continuing Education course for Optometrists presented on May 20, 2015. ===================== ---------------------- About Dr. Richardson: David Richardson, M.D. is widely recognized as one of the top #cataract and #glaucoma surgeons in the US and is among an elite group of glaucoma surgeons in the country performing the highly specialized canaloplasty procedure. Many patients have traveled from around the world to have #canaloplasty by Dr. Richardson. Moreover, Dr. Richardson is one of only a few surgeons in the greater Los Angeles area that performs Micropulse® Cyclophotocoagulation (MP3) glaucoma laser surgery. Dr. Richardson graduated Magna Cum Laude from University of Southern #California and earned his Medical Degree from Harvard Medical School. He completed his ophthalmology residency at the LAC+USC Medical Center/ Doheny Institute. To learn more about Dr. David Richardson, please visit http://david-richardson-md.com. ---------------------- We Listen. You'll See!℠ David D. Richardson, M.D. Patient-Focused Ophthalmologist San Marino Eye 2020 Huntington Drive San Marino, CA 91108 Phone: (626) 289-7856 Email: [email protected] Patient-Focused Websites: New-Glaucoma-Treatments.com About-Eyes.com ===================== TRANSCRIPTION: I have this one here - Cyclophotocoagulation is considered to be minimally invasive. So technically it fits in what we call them, "MIGS” criteria (minimally invasive glaucoma surgery). We may all recall the photocoagulation of the ciliary body that was done externally and it was a very painful procedure used only for end-stage glaucoma because it's completely anti-tratable. It either worked so ridiculously well that you ended up with a phthisical eye or it didn't work out. It was really the older style, ciliary process, ablative procedures, which was really just for treating pain; truly end-stage, blind, painful eyes. Fortunately, we now have an endoscopic technique that's pretty cool! Let me show you, we've got a video of it her. This is an animation of the procedure generally is done after cataract surgery It's endoscopic. So you can see you got this on the monitor up here and you can see the animation essentially just fries the ciliary processes and they just shrink, right. The whole purpose is to ablate or destroy the ciliary processes, which are producing the aqueous. So if you can't get the aqueous to drain properly the other option is well let's keep the aqueous from being produced. Couple of issues you might anticipate with this is how do you titrate it? Nobody really knows this procedure here Endo Cyclophotocoagulation (ECP) is hard to titrate. If you don't get enough of the ciliary process, it's essentially... nothing happens, you get no result. If you get too many, which fortunately with ECP is hard to do (it's hard to get too many) then you could end up actually with hypotony.