Cyclophotocoagulation lowers intraocular pressure in glaucoma by applying laser energy to the ciliary body. The doctor selects the treatment type and settings individually.
The indication is determined by the entire clinical picture rather than the stage alone: the type of glaucoma, current intraocular pressure, rate of progression, previous interventions and treatment goals. Patients whose IOP remains inadequately controlled despite tolerated glaucoma medication.
After previous glaucoma surgery, the procedure may be considered if the target pressure has not been achieved or the effect has subsequently become insufficient.
Patients in whom filtering or drainage surgery carries increased risk or is not preferred after informed discussion of alternatives.
For CW-TSCPC, particularly refractory or advanced disease, painful eyes and limited visual potential, while selected earlier scenarios may also occur.
An ophthalmologist or glaucoma specialist should be consulted if intraocular pressure remains above the individual target despite treatment, visual-field or optic-nerve findings show progression, drops are poorly tolerated, the prescribed regimen is difficult to follow, or previous laser or surgical treatment has not provided sufficient control.
Having glaucoma alone does not automatically indicate cyclophotocoagulation.
For MP-TSCPC, selected patients across a broader range of glaucoma types and stages, including eyes with useful vision, when the treating specialist considers the balance appropriate.
Active ocular inflammation, infection or another acute eye condition may need treatment before laser therapy.
Cyclophotocoagulation does not restore optic nerve fibres or visual field already lost to glaucoma.
Glaucoma drops may still be required after treatment; medication should only be changed by the treating clinician.
Potential adverse events include pain, inflammation, transient IOP elevation, hypotony, corneal oedema, macular oedema, reduced vision, inadequate pressure response and need for retreatment.
These risks are generally greater with traditional CW-TSCPC. Rare severe complications of cyclodestructive procedures include persistent hypotony and phthisical change.
Before the procedure, the doctor rechecks the diagnosis, intraocular pressure, anterior-segment condition and visual potential, and reviews medicines and previous operations.
Laser energy parameters and the number or duration of applications are selected individually and depend on the system, probe, technique and clinical goal.
In a painful eye with markedly elevated pressure, the doctor also assesses whether urgent pressure reduction is needed. Severe eye pain , nausea, halos, sudden loss of vision or marked redness require urgent ophthalmic assessment rather than a routine appointment.
Seek urgent ophthalmic advice after treatment for rapidly increasing pain, sudden visual deterioration, marked redness, purulent discharge, severe photophobia or other rapidly worsening symptoms.
Pregnancy is neither a stand-alone indication nor a prohibition: the decision depends on urgency, medication burden and the overall management plan agreed with the relevant specialists.
Seek urgent ophthalmic advice after treatment for rapidly increasing pain, sudden visual deterioration, marked redness, purulent discharge, severe photophobia or other rapidly worsening symptoms.
Book a consultation
Before the procedure, the doctor rechecks the diagnosis, intraocular pressure, anterior-segment condition and visual potential, and reviews medicines and previous operations.
Laser energy parameters and the number or duration of applications are selected individually and depend on the system, probe, technique and clinical goal.
Anaesthesia includes retrobulbar anaesthetic administration before treatment and anaesthetic drops during laser surgery.
CW-TSCPC delivers continuous energy in point applications; MP-TSCPC moves the probe over the selected area and delivers energy in ON/OFF sequences.
After treatment, the doctor checks the eye, prescribes anti-inflammatory and pressure-lowering therapy and determines the timing of pressure checks.
Treatment of the ciliary body helps reduce aqueous fluid production and lower pressure.
Transscleral laser treatment does not require a drainage implant or creation of a filtering bleb.
The method may be considered when other approaches do not adequately control pressure, including after previous surgery.
When indicated, the doctor may consider repeat laser treatment based on the response to the previous procedure.
Schedule a glaucoma consultation at KazRIED so the physician can evaluate your current IOP level, optic nerve status, and previous treatments.
A team of experienced doctors across specialties.
Candidate of Medical Sciences; Highest-category ophthalmologist
Highest-category ophthalmologist
Highest-category ophthalmologist
Cyclophotocoagulation (CPC) is used to lower intraocular pressure (IOP) in glaucoma. The laser targets the ciliary body, which lies behind the iris and contributes to aqueous humor production.
The goal is to achieve an individualized target IOP and reduce the risk of further optic nerve damage. The procedure does not restore nerve fibers that have already been lost.
Continuous-wave transscleral CPC (CW-TSCPC) delivers energy continuously, producing a pronounced coagulative effect. It can substantially reduce IOP but involves a greater thermal load and risks of inflammation, persistent hypotony, and rare severe complications.
Micropulse transscleral CPC (MP-TSCPC, MicroPulse TLT) alternates periods of energy delivery with pauses, allowing some heat to dissipate.
Its effects are associated with changes in ciliary body function, reduced aqueous humor production, and potentially enhanced alternative outflow.
Comparative studies report a more favorable safety profile for MP-TSCPC for several complications. However, IOP reduction and the need for retreatment depend on treatment settings, baseline pressure, and the clinical situation.
Micropulse treatment is not risk-free and does not guarantee freedom from eye drops.
Micropulse CPC may be discussed when medications are poorly tolerated, maximally tolerated medical therapy is insufficient, previous surgery has provided inadequate control, or other surgery carries a high risk.
It may be considered at different stages and in different forms of glaucoma, but indications are individualized. In angle-closure, neovascular, uveitic, and other secondary or refractory glaucomas, management depends on the cause of IOP elevation.
If pressure can be safely controlled with drops, SLT, or another intervention, CPC is not necessarily the next step.
The clinician considers glaucoma type and stage, target IOP, optic nerve condition, the retinal nerve fiber layer, visual field, anterior chamber angle, and eye anatomy.
Visual potential, inflammation, coexisting conditions, medication tolerance, and previous SLT, filtering surgery, or drainage implants are also important.
Expected effects, risks, and the likelihood of retreatment are discussed separately for conventional and micropulse modes. Pressure reduction percentages in promotional materials do not guarantee an individual outcome.
Conventional and micropulse transscleral CPC are performed on an outpatient basis. The source description gives an average duration of up to 20 minutes; individual arrangements should be confirmed before treatment.
Endoscopic cyclophotocoagulation is not included among the procedures performed in the service described.
The same procedure should not be repeated automatically. The clinician first assesses the effect achieved, tolerability, medications, and reasons for inadequate control.
Further management may include repeat MP-TSCPC, another laser approach, filtering surgery, a drainage device, or a combination of methods.
Glaucoma remains a chronic disease even after a good initial response. Follow-up monitors IOP, medications, the optic nerve, OCT findings, and visual fields.
The absence of pain or other symptoms does not establish that pressure is safe. Examination findings and clinical assessment determine follow-up timing.
Do not stop pressure-lowering drops independently. The clinician may initially maintain the previous regimen and then adjust it according to the actual IOP response and inflammation.
A diminishing effect over time does not necessarily mean treatment failure. Monitoring helps determine whether current control is sufficient or an additional intervention is needed.
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
Kazakhstan’s first specialized ophthalmology institute, operating since 1933.
Modern diagnostics and surgery using world-class equipment.
Leading ophthalmologists in Kazakhstan, scientists and experienced surgeons.
More than 30,000 operations and around 270,000 consultations annually.
