The use of endoscopic cyclophotocoagulation in the treatment of glaucoma - a literature review

Abstract Glaucoma, a leading cause of irreversible blindness, often necessitates intervention beyond conventional therapies when intraocular pressure (IOP) cannot be adequately controlled. Endoscopic cyclophotocoagulation (ECP), a targeted cyclo-destructive procedure, has emerged as a valuable surgical option due to its ability to precisely coagulate the ciliary processes under direct visualization. This literature review explores ECP's role in contemporary glaucoma management. It examines its efficacy, safety, and integration with phacoemulsification, novel hybrid procedures, such as ECP with Kahook Dual Blade or iStent insertion and vitrectomy pars plana. Clinical studies consistently demonstrate a significant reduction in IOP and medication burden, particularly when ECP is combined with cataract surgery. While complications such as inflammation and transient IOP spikes are noted, severe adverse outcomes remain uncommon. Pediatric and refractory glaucoma cases show variable responses, emphasizing the need for individualized patient selection. Comparative studies suggest that ECP provides outcomes that are on par with or superior to traditional surgical options, with a lower complication rate and preservation of conjunctival integrity, which is advantageous for future interventions. However, the predominance of retrospective studies and limited long-term data warrant further randomized, controlled trials to establish definitive guidelines. ECP represents a promising, minimally invasive strategy in glaucoma care, particularly as part of combination procedures. Growing evidence supports its clinical utility across a wide range of patient populations.