Glaucoma: a new surgical treatment by ultrasound cyclo coagogulation

The objective of any antiglaucomatous treatment is to protect the retinal nerve fibers, and thus the field of vision, by lowering the intra-ocular pressure (IOP), which is the main risk factor for glaucoma. The vast majority of the patients are treated by eyedrops among which the rhythm of administration and the tolerance are variable. However, antiglaucoma surgery in the glaucoma can be proposed when the medical treatment by eye drops is insufficiently effective, badly tolerated or in non compliant patients, or in case of disease progression in spite of an apparent IOP control. Trabeculectomy has been considered to be the reference surgical technique but non-penetrating deep sclerectomy is widely performed. This surgery is unmistakably original, stimulating intellectually speaking and equally effective on IOP.Laser trabeculoplasty is also an alternative to the surgery and the goal of the procedure is to focus high-energy laser beams on the trabeculum meshwork, which is the anatomical filter of drainage of aqueous humor. More recently, new lasers delivering energy to selective trabecular cells have been developed; these techniques give the same results on pressure while reducing the induced inflammatory ocular response. Finally, surgical techniques decreasing the production of the aqueous humor by coagulation of the ciliary processes, by laser but also high-intensity focused ultrasound impacts, are also very innovative and promising for the treatment of glaucoma.