Cycloablation in Dogs

Cycloablation is a glaucoma-responsive laser procedure popular among both dogs and humans, with the word ‘ablation’ signifying the procedure’s main goal of ablating, or eroding, the ciliary layer of the eye. Sometimes referred to as endocyclophotocoagulation (ECP) or cyclophotocoagulation (TS-CPC), this procedure utilizes several different lasers and light sources to operate on the eye while damaging the least amount of surrounding tissues. 

The goal of cyclophotocoagulation is to destroy the ciliary body – a part of the eye that gives it curvature, as well as mediates oxygen and nutrients to eye tissues. Cyclophotocoagulation (CPC) punctures the ciliary epithelium, which naturally regenerates itself, relieving the eye of pressure. If a pet is in need of this procedure, a veterinarian is likely to recommend an ophthalmologist (a doctor trained in the diseases of the eye). 

Pre-Operative

After multiple exams and conversations with your veterinarian, a referral to a canine ophthalmologist may be given to you. The dog will undergo necessary bloodwork and urinalysis to determine any risks that could be involved during surgery. For instance, any test results that illuminate heart conditions or diabetes will give the ophthalmologist and surgery team an idea of what complications to anticipate, if any at all. Right before surgery, anesthesia is administered as the procedure is painful and requires the patient to lie very still. A catheter may also be installed as the procedure may be relatively lengthy. 

Peri-Operative

There are different techniques utilized in cycloablation: transscleral CPC (TS-CPC) and endocyclophotocoagulation (ECP). During the procedure, either a diode laser (TS-CPC) or endoscopic probe (ECP) works to saturate the ciliary epithelium and reduce or cease intraocular pressure. ECP is relatively new, with the surgeon working alongside lights, a microscope, and cameras in order to pinpoint ciliary processes, eye ligaments, and rectify them.

Lasers create microscopic holes in the exterior eye tissue, reaching deeper tissues where the ciliary processes rest. Each ciliary process is focused upon with a curved utensil (endoscopic probe) and aims to whiten and visibly reduce inflammation. TS-CPC represents the original means of performing cycloablation surgery; it’s still preferred by some ophthalmologists as the ciliary body responds well to the diode laser. 

Post-Operative

In most cases, dogs are released home after the procedure, but not without instruction and medication prescriptions. Eye drop medications, typically steroids, are assigned to the owner to administer to help with healing and inflammation. The dog is slowly weaned off any pre-operative medications that alleviate glaucoma symptoms. 

In terms of effectiveness, cycloablation procedures are successful, incurring little complications during operation. However, its benefits can be short-lived and follow-up laser surgeries are sometimes recommended. Often this depends on the severity of glaucoma, as well as the dog’s already degraded vision. Dogs receiving this cycloablation procedures with good to excellent vision are more likely to obtain satisfactory results when compared to dogs with decent to bad vision. In other words, some dogs make more ideal patients for cycloablation. 

Typically, veterinarians witness TS-CPC canine patients with the same vision or slightly improved post-operatively. Their intraocular pressure is reduced, allowing for less reliance on glaucoma and pain medications. This is also the case for dogs experiencing ECP; however, a slight rate of postoperative adverse effects has been documented.  

Following cycloablation treatment, you and your dog should expect to see results within three to six weeks. In rare cases, results may take as long as 14 weeks to appear. The good news for both pet and owner is that cycloablation procedures often require little to no post-operative care, allowing the dog to leave the veterinarian’s office in as little as thirty minutes to an hour after the procedure is completed. However, you won’t be sent home without instructions or medications. Topical eye creams and/or drops are prescribed, as well as pain medication and an anti-inflammatory to help with healing. 

With each check-up after the procedure, glaucoma medications will be slowly lessened depending on the eye’s response to the treatment. An eye patch may be necessary for the first few days, just to lower probability of foreign bodies or inflection. Post-operative appointments, one week, one month, three month, and six months out will let you and the veterinarian know exactly where the dog is in their healing process. 

As with most surgical procedures, cost can be an issue. Glaucoma is a frustrating disease for both pet and pet owner, as it creates a lot of discomfort, loss of vision, and may even escalate despite the best efforts. Cycloablation procedures are often a last, yet necessary, resort for a dog’s health, happiness, and safety. Ophthalmologists report eye surgeries costing between $1,200 and $4,000 when incurring no peri or postoperative complications. 

There are no alternative routes when it comes to treating glaucoma effectively without over-prescribing medications, causing your dog to become heavily medicated and not themselves.

Any surgical procedure is not complete without its list of potential complications and risks. Cycloablation is no different. Anterior segment necrosis is an adverse development commonly occurring in postoperative patients of CPC. Irregular, toxic inflammation stirs in the eye and can cause intraocular tissue damage. 

Other side effects include:

• Prolonged hypotony
• Pain and discomfort while healing
• Uveitis
• Hemorrhage
• Choroidal effusion
• Scleromalacia
• Failure and need to re-treat

Despite some possible postoperative developments, the procedure is quick and painless for the animal and can be the difference between a normal, happy life and a muted one. It can also be the difference between the dog being able to see and slowly becoming blind.

Discuss signs of glaucoma with a vet.

Annual visits to the vet’s office will benefit both you and your dog, as you’ll draw on their wealth of knowledge. If you’re worried your dog is developing glaucoma or know that he or she is predisposed to it, ask your veterinarian to pay special attention to eye health at each appointment. Early signs of glaucoma, found when the vet checks the intraocular pressure of the eyes, can lead to effective treatment. If glaucoma develops in one eye, your veterinarian will continue to routinely observe the other eye, ensuring both eyes don’t become diseased. 

Avoid tight collars.

Some studies show that tight collars or frequent tugging on a collar may increase the intraocular pressure of a dog’s eyes. You should be able to fit at least two to three fingers into the dog’s collar comfortably. Anything less may show that your dog’s collar is too tight. Also, consider purchasing a dog vest for walking instead of a collar that tightens. 

Don’t skip the eyes during baths.

When bathing your dog, spend time on the eyes. Soak a soft cloth in warm water and gently wipe at the eyes and their surrounding area. If your dog has glaucoma, be sure to do this gingerly as it could be painful for them.