Endocyclophotocoagulation (ECP)

What is Endocyclophotocoagulation (ECP)?

ECP is often combined with cataract surgery to help reduce intraocular pressure. The procedure involves coagulation of the ciliary processes under direct visualization so as to cause inflammation and scarring with subsequent decrease in the amount of intraocular fluid produced within your eye. Since glaucoma usually involves a drainage problem, reducing the amount of fluid being made helps with the intraocular pressure.

After cataract surgery is completed a 20G special probe is introduced into the eye through the same cataract incision. This probe has both a special camera as well as fiberoptic cables that will help deliver the laser energy. Your surgeon will observe the internal structures of your eye on a TV monitor and will direct the laser energy to the ciliary processes under direct visualization. The amount of energy delivered is titrated to achieve a blanching of the processes. An attempt is made to treat about 270 to 360 degrees around the eye to achieve maximal effect.

After the procedure an eye patch will be placed over your eye for the first 24 hours. Your doctor will want to examine you in the office the following morning when the patch will be removed and your eye pressure checked. You will be prescribed a regimen of postoperative drops for the next four to six weeks.

If the procedure is successful you can expect a decrease in the intraocular pressure and you possibly may come off some of your glaucoma medications. It takes about 6 to 8 weeks before the outcome of the laser procedure is known.

The procedure takes about 15 minutes to perform. Prior to the procedure, a topical anesthetic drop is placed on the eye and a contact lens is placed on the eye. The laser applications are made through a microscope that looks similar to the one your doctor examines your eye with in the office. Once the laser is completed, you will have to wait for a period of time to have your eye pressure checked. Allow 2 hours for the entire procedure. You will need to use an anti-inflammatory drop in the eye for several days following the procedure.

Several postoperative visits will be scheduled to monitor your eye pressure. Expect several weeks before your doctor sees a lower pressure in the eye treated. Early results show that the laser may be repeated if necessary.

Benefits of the laser include no adverse events from added medications and the delay of a surgical procedure. Please feel free to discuss this laser or other procedures with your physician.