What is the role of cyclodestructive procedures in the treatment of penetrating keratoplasty and glaucoma (PKPG)?

Updated: Dec 30, 2020
  • Author: Shibandri Das, MD; Chief Editor: Inci Irak Dersu, MD, MPH  more...
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Answer

Cyclodestructive procedures are designed to control IOP by decreasing aqueous humor production by destroying part of the ciliary body. Cyclocryotherapy, transcleral cyclophotocoagulation with Nd:YAG, and semiconductor diode laser are the various cyclodestructive procedures that can be performed on patients with intractable PKPG. The reported success rates, as defined by decrease in IOP, and the complications after any of these procedures appear to be similar. [73, 74, 75]  The individual surgeon must decide which procedure to use, depending on the availability of the instruments and the lasers.

The overall success rate in controlling IOP is 60 to 80%. The major potential complications of any of these procedures are risk for graft rejection (11-65%), loss of vision (22-56%), and phthisis bulbi. [30, 76, 77]

Other complications include persistent hypotony (5-10%), anterior uveitis, epithelial defects, hyphema, hypopyon, intractable pain, sympathetic ophthalmia, scleral thinning, and vitreous hemorrhage. [78]


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