Question: What is cyclodestructive surgery, when is it used to treat glaucoma, and what are the risks/benefits?
Answer: Cyclodestructive procedures are when we use a laser, either delivered from the outside part of the eye or by inserting a probe inside the eye directly visualizing the ciliary body, to destroy parts of the ciliary body. The ciliary body is the tissue inside the eye that produces the fluid. If we think of the eye and intraocular pressure like a sink, where fluid is being produced and comes into the eye from the faucet or the ciliary body and then drains through the trabecular meshwork or the drain of the eye, these procedures attempt to turn down the faucet.
However, the fluid that's produced by the ciliary body is healthy for the eye. It's natural and normal. The problem with glaucoma is poor drainage, in which the drain doesn't work. In general, cyclodestructive procedures are only used after all medication, laser and incisional surgical options have been exhausted. However, there are some diagnoses and certain circumstances in which we might use cyclodestructive procedures as first line treatment -- in other words, the very first treatment that a patient might receive. However, these are usually very isolated circumstances.
It's important to talk with your ophthalmologist to find out what treatment might be best for you. Furthermore, these types of strong laser procedures can have very significant side effects, such as bleeding or pressures that are far too low for the eye. Again, as I said, it's very important to consult with your treating ophthalmologist to have the cyclodestructive procedure.