Our guest surgeon and noted glaucoma expert, Professor Ramesh Ayyala, demonstrates the technique of cyclo cryo ablation to help control recalcitrant glaucoma in this tough case with a chronic corneal ulcer. Cyclo-cryoablation is a destructive procedure used to lower intraocular pressure (IOP) in cases glaucoma where conventional medical, laser, or surgical treatments have failed or are not possible. The technique involves applying a cryoprobe to the sclera overlying the ciliary body, typically in 180 degrees of treatment. The cold temperature causes localized destruction of the ciliary processes, thereby reducing aqueous humor production and lowering IOP. It is often reserved for eyes with poor visual potential due to its risk of complications, which can include inflammation, hypotony, phthisis bulbi, or even vision loss. However, with proper technique and patient selection, it can be a valuable palliative option to relieve pain and reduce pressure in eyes with uncontrolled glaucoma. Cyclo-cryoablation remains a useful tool in the management of refractory glaucoma when other options are exhausted.
