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A patient underwent laser cyclophotocoagulation using the g-probe with the cyclo g6 console for the management of medically refractory glaucoma.Following the procedure, the patient developed choroidal effusions that were subsequently complicated by a suprachoroidal hemorrhage.The treating physician reported that the patient was on dual antithrombotic therapy, which significantly increases the risk of ocular hemorrhagic complications.No device malfunctions were noted during the procedure.The device was returned for servicing but no issues were found.The physician selected laser treatment as a less invasive alternative to incisional surgery, given the elevated bleeding risk associated with the patient's anticoagulation status.The treatment parameters used during the procedure differed slightly from the instructions for use (ifu) recommendations.The ifu suggests a power setting of 1500 mw with a duration of 3500 ms per application and approximately 18-21 treatment spots over 270 degrees of the ciliary body.In this case, the physician initiated treatment at 1500 mw and titrated power upward in 5 mw increments per spot, reaching a maximum of 2000 mw.The duration per application remained consistent with ifu guidance at 3500 ms; however, the total number of spots applied was 16, which is slightly fewer than the recommended range.This deviation likely was based on physician judgment and patient-specific considerations.The ifu explicitly states that treatment parameters are suggested and that the physician is responsible for determining appropriate settings for each case.In this instance, the patient's clinical status; including the use of dual anticoagulant therapy and associated elevated hemorrhagic risk necessitated a cautious and individualized approach.Based on the findings, the root cause of the event is most likely patient-related factors, specifically the heightened hemorrhagic risk due to dual antithrombotic therapy.Suprachoroidal hemorrhage is a known but uncommon complication of glaucoma procedures, and its likelihood increases significantly in anticoagulated patients.The choice of laser cyclophotocoagulation over incisional surgery was clinically appropriate to minimize bleeding risk, although hemorrhagic complications can still occur in high-risk individuals.There is no evidence to suggest that the g-probe or cyclo g6 console malfunctioned or contributed to the event.
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