Transscleral ciliary laser photocoagulation (CTCP) is a novel ciliary body disruption procedure that is now considered an effective treatment for refractory glaucoma. Refractory glaucoma is defined as patients with all types of glaucoma who cannot be controlled with the maximum amount of IOP-lowering medications and who cannot be controlled with anti-glaucoma surgery. This laser is generally used in advanced glaucoma patients who are refractory and have poor vision, but we are currently trying to use the ciliary body laser as an initial surgical treatment for glaucoma types that are not expected to respond well to conventional surgical treatments, such as juvenile glaucoma, neovascular glaucoma, and secondary glaucoma in silicone oil eyes when medications have not been effective. Transscleral ciliary body laser photocoagulation has a positive effect on lowering intraocular pressure (IOP). Almost all patients have a decrease in IOP on the second day after surgery, and thereafter the IOP can decrease further, and most patients have a stable IOP in about 2 weeks, but some patients are not sensitive to the treatment and need multiple treatments. Patients who are male, young adults, and whose type is neovascular or traumatic have poorer outcomes and are likely to require repeat treatments. There are risks associated with this treatment, i.e., some patients may experience the following: 1, anesthetic accident 2, cardiovascular accident 3, infection 4, anterior chamber hemorrhage 5, anterior chamber inflammatory reaction 6, visual acuity loss 7, cataract exacerbation 8, ciliary body choroidal detachment, retinal detachment 9, low intraocular pressure, atrophy of the eyeballs, sympathetic ophthalmoplegia 10, conjunctival congestion and edema, and thinning of the sclera. Particularly important to note is the risk of vision loss, which occurs in about 1-2 out of 10 patients, so we generally do not perform this treatment in patients with visual acuity higher than 0.3. However, in patients with certain types of glaucoma who have good visual acuity but have a high failure rate for conventional trabeculectomy, and who expressly do not want to try conventional treatment, we have used ciliary body laser treatment in these patients, and no serious complications have been seen, and the majority of patients have had a satisfactory outcome. This treatment needs to be performed under balloon anesthesia, there is no obvious discomfort during the operation, but a few hours after the anesthetic wears off, there will be obvious eye pain with headache, these are the reactions of the ciliary body being destroyed by the laser, which is normal, and can be taken orally to relieve the pain. The headache lasts for 3-5 hours and disappears. In a few patients, mild eye pain may last for several days. Postoperative conjunctival congestion (i.e., redness of the eye) is also normal, lasting about 10 days and gradually disappearing. In some patients, the conjunctival blood vessels are thickened and congested by stimulation, and the redness of the eye caused by this condition may not disappear. Ciliary body laser is the “ultimate weapon” for glaucoma, the premise of using this treatment is that all kinds of treatments have been tried but can not control the intraocular pressure, but this does not mean that the ciliary body laser can control the intraocular pressure of all patients, that is to say, there are some people who can not control intraocular pressure with the use of ciliary body laser. If the ciliary laser still cannot control the IOP but the patient still has vision, it is quite tricky medically because it is difficult to find other ways to control the IOP and the patient may end up losing their vision, in which case we will talk to the patient to find possible ways; if the ciliary laser still cannot control the IOP but the patient does not have vision, eye removal can be considered. Routine postoperative medications include: 1, Pariet (1% prednisolone acetate) Once every 2 hours on the day of treatment, and then changed to 4 times/day for 7 days on the next day; thereafter, changed to 3 times/day for 7 days. 2, Atropine eye drops: 3 times/day for 14 days Note on medication: 1, laser-treated eyes use the above two kinds of ophthalmic drugs, and not used in non-laser eyes. 2, the eye pressure lowering ophthalmic drugs used before the operation, need to continue to use after the operation, the intraocular pressure down to normal and then stop. 3. For non-laser treated eyes, continue to use the medication prescribed by other doctors. 4.All eye drops, no need to use at night when sleeping. Patients must have regular follow-ups, which will be on the first day, 1 week, 2 weeks, 1 month, 3 months, 6 months, 9 months, and 1 year after surgery. Thereafter, follow-up appointments may be made semi-annually. Each follow-up visit requires examination of visual acuity, intraocular pressure, anterior segment, and a decision on further management as appropriate.