Cyclodiode laser is a procedure performed to lower the eye pressure using a laser heldagainst the outside of the eye. The procedure is usually carried out in the operating theatre under a local anaesthetic. Normally, eye pressure is controlled by the balance of productionand drainage of a fluid called aqueous humour. The laser is directed towards the area of the eye that produces the fluid. The laser causes less fluid to be produced and so the pressure of the eye is reduced.
Cyclodiode laser is performed in the operating theatre so you will be given an operation date and arrival time. After arriving at the ward, you will be checked in by a member of the nursing team. You willalso have an opportunity to discuss the procedure further with a member of the medical team.
The ward staff will get you ready for theatre and you will be taken to the anaesthetic room. Typically the laser is performed under local anaesthetic whilst you are lying on a bed. Youreye will be held open by a small clip. The anaesthetist commonly uses a blunt needle to fill the tissues around the eye with local anaesthetic. This is a very effective anaesthetic that works for several hours. While you may feel some pressure around your eye when the anaesthetic is being given, this then makes the cyclodiode laser procedure painless.
The laser is performed using a pen like device that is held against the side of the eye. The procedure itself takes around 10-20 minutes to perform. The eye is covered with a patch after the procedure to protect it until the anaesthetic wears off. Typically, you will go home the same day with an appointment to return for review in clinic. Your vision will return as the anaesthesia wears off but your eye may feel a little sore. If you are experiencing more than regular soreness, you can take some regular pain relief that suits you (your doctor can advise you on this if you are unsure).
The benefit of cyclodiode laser is to reduce the eye pressure in situations when the eye pressure is too high and causing damage to the optic nerve or causing you significant eye pain. The full effect of the laser can take weeks to become apparent. You can continue with your usual drops and medication afterwards and we will advise you if they can be reduced or stopped.
The common risks of cyclodiode laser are that the eye can be red and sore afterwards. This is usually due to inflammation caused by the laser and this is why anti-inflammatory drops are required to help control this. We also sometimes give antibiotic drops to reduce the risk of infection. As we do not operate within the eye, there is very little risk of infection within the eye itself. You will be seen in clinic after the laser to assess its effect on eye pressure.
Sometimes the laser can lower the pressure too much. The amount of pressure lowering and how long the reduction in pressure lasts can vary between patients. If there is an inadequate pressure reduction, or if the pressure rises again with time, it is possible to repeat the procedure. Very rarely, the laser can cause severe bleeding or loss of vision which may be permanent.
The purpose of this procedure is not to improve your vision but to reduce the eye pressure, which should help preserve the vision you currently have or reduce eye pain.
Cyclodiode laser can be performed as both an emergency and scheduled procedure. If you have been told you will be having an emergency procedure and have not heard back about when your procedure is, please contact the secretary of the consultant in charge of your care through the hospital switchboard on 020 7253 3411.
If you are having cyclodiode as a scheduled procedure then you should call the appointments contact centre, either via the hospital switchboard on 020 7253 3411, or via thenumber given to you by your local Moorfields networked site (i.e. Moorfields at Bedford).
Authors: Richard Imonikhe and Anthony Khawaja
Review date: January 2022