Endoscopic CycloPhotocoagulation (ECP)

Endoscopic CycloPhotocoagulation or ECP, is an exciting development in the management of many types of glaucoma including the more common open-angle glaucoma and narrow-angle glaucoma. ECP is performed on an outpatient basis. In this procedure, the ciliary body of the eye, which creates fluid, is treated with a laser. This reduces fluid production that in turn, reduces intra-ocular pressure. The ciliary body is a small gland running around the circumference of the eye located behind the iris.

If one simply thinks of an eye as a water balloon attached to a slowly running faucet, with a drainage leak in the balloon allowing water to run out as fast as it runs in, then glaucoma represents a clogging of the drainage area, so that water runs in from the faucet faster than it gets out through the drain.  This leads to increased internal water pressure that eventually causes damage to the optic nerve.  While most conventional glaucoma procedures work by trying to improve drainage by creating a permanent "leak", these procedures often fail because the body's own healing mechanisms may heal the "leak" closed. ECP on the other hand, represents a BREAKTHROUGH TECHNOLOGY  in that it is the first safe and effective treatment that attacks the "faucet" rather than attacking the "drain". The advantages of this are substantial: 

1. The procedure is highly effective in lowering presure.
2. By being far "KINDER AND GENTLER" to the eye, the post operative course is much smoother, requires many fewer office vistis, and has remarkably fewer bothersome and sometimes medically serious side effects and/or complications compared to standard "leak" surgery.
3. Success is NOT dependent on foiling the body's tendency to heal the "leaks".
4. It can safely and effectively be repeated if needed, because it is so gentle to the eye.

The ciliary body of the eye, which creates fluid, is treated with a laser.

ECP allows the surgeon to view the area through an endoscopic camera, which aids in the very precise placement of the laser beam used for treatment.

Endoscopic CycloPhotocoagulation  can be and is often performed on patients at the time of cataract surgery.  In fact, it is felt by many surgeons to be so effective, yet so safe, that they perform it 100% of the time during cataract surgery on patients who also have glaucoma. It can also be performed on those patients who had SLT or ALT laser procedures, glaucoma filtration surgery or other surgical procedures that were not successful at controlling intra-ocular pressure.

ECP has proven to be an effective way to reduce intra-ocular pressure, and because its safety ratio is so high, it can be safely performed in early stages of glaucoma to help eliminate or reduce eyedrops, along with their inconvenience and substantial costs. Studies have shown that the majority of patients have their glaucoma medications reduced or completely eliminated after the procedure and are no longer at risk of loss of vision from glaucoma.

Let's face it, it is the extremely rare glaucoma patient who is 100 % faithful in taking the correct eyedrops, at the correct time and dosage, day in and day out for a lifetime.  And the lack of doing just exactly that is a major reason why so many glaucoma patients eventually develop serious damage to their optic nerve and vision.  And since glaucoma has virtually no symptoms, patients are lead to believe that because they experience no perceptable change in vision, discomfort, etc., when they miss their drops, that they are getting away scott free.  Unfortuantely, by the time vision damage is finally discernible to the patient, it is late in the game and SEVERE PERMANENT DAMAGE has been done.  So a highly SAFE AND EFFECTIVE procedure like ECP, that can potentially eliminate the need for medications, and therefore potentially provide proper glaucoma control 24 hours a day, day in and day out, may not only get the EYEDROP MONKEY' off you back, but also SAVE YOUR VISION with more constant pressure control.

Endoscopic CycloPhotocoagulation is for those who:

• have glaucoma, "glaucoma suspect", or higher than normal intra-ocular pressure, including those with cataracts
• who want to get the "EYEDROP MONKEY" off their backs.
• will not or cannot  be 100% faithful in using their eyedrops every single day, whether due to the high cost of medications, side effects, forgetfulness, or physical (arthritis, etc.) or mental (Alzheimer's, Parkinson's etc) disabilities
• have not responded well to medications and other surgical treatments  
• have had multiple prior glaucoma procedures that have either been completely or partially unsucessful.

What to expect on procedure day:

ECP can be performed either by itself or at the same time as cataract surgery (immediately after the cataract is removed with no additional incisions required). The ECP probe uses tiny, optical fibers to illuminate, view and treat the ciliary body with laser energy. Approximately 20 to 40 laser applications will be administered.

Your eye pressure will be checked shortly after your procedure and drops will be prescribed to alleviate any soreness or swelling inside your eye. You may also receive oral medications to control inflammation.

You should relax for the rest of the day. Follow-up visits are necessary to monitor eye pressure. It may take a few weeks to see the full pressure-lowering effect of this procedure. Most patients resume normal activities within a few days.

Realistic expectations:

The large majority of patients experience sufficient pressure reduction that they can reduce or eliminate their glaucoma medications.  While the effect of the surgery sometimes gradually wears off over time, this procedure is much "KINDER AND GENTLER" to the eye than conventional procedures, and can be repeated in the future with excellent success. However, because vision damage from glaucoma is permanent, this procedure and other glaucoma surgical procedures do not restore lost vision. Serious complications with Endoscopic CycloPhotocoagulation are rare, but like any surgical procedure, it does have some risks. Prior to your procedure, you will be given additional information that will allow you to make an informed decision. Be sure you have all your questions answered to your satisfaction.

If you would like more information about this procedure you can make an appointment or contact the office for additional information.