Endoscopic fluorescein angiography of the ciliary body in glaucoma management

BACKGROUND AND OBJECTIVE: The laser endoscopy system has been modified to permit high-resolution intraoperative fluorescein angiograms. Because the ciliary processes can be directly viewed and photocoagulated from a limbal wound in the phakic, aphakic, or pseudophakic eye in virtually any patient, the novel opportunity to angiographically study the ciliary processes before and after various forms of ablation was created. PATIENTS AND METHODS: Eighty patients were divided into four groups and were studied under various conditions. RESULTS: The ciliary processes normally fill with fluorescein early in the angiogram and maintain hyperfluorescence throughout. Functional ciliary processes (or portions of them) are hyperfluorescent; ablated processes are densely hypofluorescent. This technique can delineate inadequately treated zones, permitting appropriate correction at the time of initial surgery. Eyes with previous transscleral cyclodestruction did not experience the degree of ciliary process ablation that the surgeon reported. CONCLUSION: Intraoperative delineation of treated and untreated ciliary processes permits accurate correlation with observed intraocular pressure response.