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Endocycloplasty

Management of Narrow Angle Glaucoma due to Plateau Iris Sydrome

ENDOCYCLOPLASTY 

A New Technique for Managing Angle Closure Glaucoma Secondary to Plateau Iris Syndrome


Iqbal (Ike) Ahmed, MD; Dominik Podbielski, MD; Devesh K. Varma, MD; Diamond Y. Tam, MD; 

University of Toronto, Department of Ophthalmology, Toronto, Canada 


Glaucoma Today, Fall Edition, 2010, pp. 28-31
Click Here for Dr. Ike Ahmed's Article

Plateau Iris Syndrome is characterized by a narrow peripheral anterior chamber angle caused by large and anteriorly rotated ciliary processes.

 

In many cases peripheral iridotomy and laser iridoplasty are inadequate to open the angle.  In these patients cataract extraction with IOL may be combined with endoscopic laser treatment to change the shape and size of the ciliary processes and thus reconfigure the angle anatomy.

 

Endocycloplasty, which was first described by Ike Ahmed, MD, and colleagues at the University of Toronto, the ciliary processes are treated in a similar fashion to Endocyclophotocoagulation (ECP), but with less laser energy, and no treatment of the spaces in between processes, (unless additional IOP lowering is also desired).  In addition, the processes are typically treated from the posterior forward, in order to cause the anterior portion of the processes to shrink posteriorly, away from the iris.

 

Dr. Ahmed’s biomicroscopy data show that the angle is opened widely after lens extraction and endocycloplasty (sometimes also referred to and endoscopic cilioplasty), but the angle is still narrow in the same eye untreated by endocycloplasty.
In In the video below, Boris Malyugin, MD, PhD, Chief of the Department of Cataract and Implant Surgery and Deputy Director General at the S. Fyodorov Eye Microsurgery Complex in Moscow, Russia explains his technique of suturing dislocated IOLs into the sulcus under direct endoscopic view.

ENDOSCOPY IS A BREAKTHROUGH TECHNOLOGY
      FOR OCULAR TRAUMA SURGEONS  
 
     Military Hospitals and Leading Ocular Trauma Referral Centers Around the Globe use Endo Optiks Ophthalmic Laser Microendoscopy Systems to manage difficult ocular trauma.
  Endoscopy brings numerous advantages to ocular trauma surgeons, with helpful wide field views to assess damage and plan surgical strategies, and magnified views to carefully treat.

ENDOSCOPY BREAKTHROUGH TECHNOLOGY FOR 

OCULAR TRAUMA SURGEONS  

Military Hospitals and Leading Ocular Trauma Referral 
Centers Around the Globe use Endo Optiks Ophthalmic 
Laser Microendoscopy Systems to manage difficult ocular 
trauma.

Endoscopy brings numerous advantages to ocular trauma 
surgeons, with helpful wide field views to assess damage 
and plan surgical strategies, and magnified views to 
carefully treat.