Clinical Scorecard: A Long-Awaited Upgrade for Endoscopic Cyclophotocoagulation

At a Glance

Key Highlights

• Leos platform offers enhanced digital visualization with a 40,000-pixel sensor, 120° field of view, autofocus, and auto-illumination.
• Single-use VueProbe laser endoscope eliminates variability and fragility issues of reusable fiber optic probes.
• Automated features and streamlined workflow reduce need for multiple staff and improve surgeon independence.

Guideline-Based Recommendations

Diagnosis

• Identify glaucoma patients who may benefit from ECP as part of IOP management during cataract surgery.

Management

• Use Leos system for precise, wirelessly activated laser treatment of ciliary processes under direct visualization.
• Employ single-use VueProbe to ensure consistent image quality and reduce risk of probe damage.

Monitoring & Follow-up

• Monitor postoperative inflammation, which may be reduced due to improved visualization and controlled treatment.
• Assess IOP reduction efficacy, including potential for expanded treatment of posterior ciliary processes.

Risks

• Overtreatment risk is lowered with improved visualization, potentially reducing postoperative inflammation.

Patient & Prescribing Data

Patients undergoing cataract surgery with coexisting glaucoma requiring IOP reduction

Leos system facilitates safer and more effective ECP with improved visualization and workflow, potentially expanding use among surgeons.

Clinical Best Practices

• Set up Leos system and VueProbe prior to surgery to streamline intraoperative workflow.
• Utilize automated image orientation, autofocus, and illumination to maintain optimal visualization without additional staff.
• Consider expanded treatment of posterior ciliary processes (ECP+) for advanced glaucoma cases.
• Train surgical staff on simplified system controls to enable efficient procedure setup and execution.

References

• BVI Leos Platform FDA Clearance and AAO Launch
• Endoscopic Cyclophotocoagulation Clinical Insights