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    Optimizing CPC treatment outcomes with built-in transillumination

    Probe enables physicians to locate ciliary body, deliver therapy in more targeted manner


    Transillumination technique

    When performing standard TSCPC, optimal placement for the probe has long been an issue for debate.15,16 Typically, probes are placed about 1.5 mm posterior to the limbus for noncontact treatment17,18 and 0.5 to 1 mm posterior to the limbus for contact cycloablation.19

    However, there is variability in the location of the ciliary body, not only in different eyes,20 but also in different quadrants of the same eye.21 Refractive error may also affect position of the ciliary body.21 Therefore, depending on where the probe is placed, it is possible that treatment is not being directed to the appropriate area. Clinicians are, essentially, blindly treating with the laser.


    To combat this variability, I have utilized a light in the past in order to illuminate the eye and improve visualization of the ciliary body. Results were much more accurate and effective when using illumination and I eventually spoke with the manufacturer about creating a probe that included an illumination component. Together, we worked to develop a targeted CPC probe with built-in transillumination (G-Probe Illuminate).

    The wedged-tip of the probe is designed to be positioned directly on the eye, allowing for precise placement while the light illuminates the anterior margin of the ciliary body. This is useful with patients who have conditions resulting in abnormal ocular size, when the limbus is difficult to visualize, in cases of high myopia, and post-corneal transplant patients, as the ciliary body may be more posterior.

    Treatment with this probe can be used on a variety of patients, whether they have open- angle or angle-closure glaucoma, in conjunction with cataract surgery, or as a stand-alone procedure.

    I typically use this optimized probe on patients with uncontrolled glaucoma who are taking two to four medications. I also prefer eyes that are “quieter,” without an inflammatory element, as any time there is inflammation there is a risk of causing further complications.

    This optimized probe allows for an efficient, straight-forward, single-handed procedure that enables treatment with less power and results in significantly improved outcomes, with patients experiencing 30% to 50% IOP reduction rates. Less power and more precise treatments also reduce complications related to unnecessary tissue destruction.

    This probe can also potentially be used in the office as opposed to the operating room, creating greater convenience and accessibility.

    TSCPC has undergone an evolution in safety and efficiency with the micropulse CPC treatment. Now, standard TSCPC treatment has evolved with the ability to illuminate the eye for more precise treatment, an invaluable enhancement clinicians are only just beginning to explore.




    Steven D. Vold, MD

    E: [email protected]

    Dr. Vold is founder of Vold Vision, Fayetteville/Bentonville, AR. He is a consultant for Iridex and receives royalties from G-Probe Illuminate.



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