AnesthesiaRetrobulbar or peribulbar injection of a 50:50 mixture of 2% lidocaine and 0.75% bupivicaine with hyaluronidase
G probe positioningThe G probe footplate is placed on the conjunctiva with the short side adjacent to the limbus, which positions the fiberoptic tip 1.2 mm behind the limbus. The ciliary body should be identified with transillumination as its position may vary and the placement of the G probe is adjusted accordingly173
Scleral transilluminationThe fibre optic light source is directed approx. 4 mm posterior to corneoscleral limbus to identify ciliary body by transillumination. The dark demarcation line indicates the anterior margin of the ciliary body
SettingsRecommended setting: duration of 2 sec., from 1500 mW for dark to 2000 mW for light-coloured irides and increase the energy until an audible »pop« is heard indicating tissue disruption. If a »pop« sound occurs during two sequential subsequent laser applications, the power is reduced by 150 mW and treatment completed at this power174
Applications10-20 over 180°, energy 5-6 J per pulse, total treatment per session up to 270° of circumference avoiding 3 and 9 o'clock positions (to avoid long posterior ciliary nerves). Some surgeons prefer to use low energy and more applications. Retreatments are often needed, but the incidence of severe complications is low [II,D].