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Selective Laser Trabeculoplasty as a First-line Treatment

The glaucoma surgical landscape is evolving and changing dramatically as we move forward in the era of interventional glaucoma. The interventional glaucoma mindset represents a significant paradigm shift in patient care, taking the treatment burden out of the patient’s hands and placing more emphasis on earlier laser intervention.

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SLT: Positive implications from the LiGHT study

Glaucoma is a lifelong disease that requires continual monitoring and management. For many patients, glaucoma can be controlled medically—at least for a time—but the treatment is far from perfect. Complications, side effects, and compliance are common issues for those who rely on eye drops to control IOP. Other barriers to medical treatment include nonresponse to a medication, tachyphylaxis, and financial burden.

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SLT as Frontline Therapy

Selective laser trabeculoplasty (SLT) has come a long way in the last few years. The practice is gaining adherents as a first-line treatment for open-angle glaucoma for multiple reasons. And to give SLT a boost and provide an uber-coherent overview of the reasons in favor of SLT, Dr. Paul Singh spoke on its behalf at ESCRS 2022 in Milan.

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The role of Selective Laser Trabeculoplasty as a primary and secondary treatment

Glaucoma is the most common optic neuropathy. The only clinically proven treatment is to reduce IOP by using medical, laser, and surgical therapies. Treatment is typically selected depending on the level of IOP, stage of the disease, pace of progression, and current and past treatment history. Glaucoma management with drops can be problematic, mainly because they can be difficult for patients to instill properly and because of the related side effects.

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Let There Be (Laser) Light

From 2019 to 2020, I co-chaired the European Glaucoma Society (EGS) Guidelines Committee with Carlo Traverso. The 5th Edition of the EGS guidelines was published in October 2020, after a superb team effort among a large number of colleagues (1). We aimed to promote evidence-based clinical practice and, to that end, followed GRADE methodology, including identification of key questions, critical evaluation of published literature, and formulation of recommendations.

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Subliminal Cyclophotocoagulation

Glaucoma is a leading cause of irreversible blindness affecting approximately 60 million people globally 40 years of age and older.􀄦 Glaucoma is a disease that cannot be ignored, and the need for signi􀃶cant changes in how we diagnose, manage, and treat must be examined and applied whenever possible.

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Ranking Laser in Glaucoma Treatment

Glaucoma management has traditionally taken a stepped approach based on the level of risk involved. The low-risk treatment option is medication. Next are laser/selective laser trabeculoplasty (SLT), MIGS, and incisional surgery. It ends with the highest risk option of cyclodestructive procedures.

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Subliminal Diode Treatment of the Ciliary Bodies by Transscleral Cyclophotocoagulation with a 31.3% Duty Cycle in the Treatment of Refractory Glaucoma: Safety and Efficacy

Micropulse Transscleral diode laser cyclophotocoagulation (MP-TSCPC) is an established method of treatment for refractory glaucoma. This study evaluates the efficacy in terms of reduction in intraocular pressure and/or treatment amount, and safety and side effects of the ciliary bodies using a subthreshold laser with a duty cycle of 31.3% with Supra 810 nm Subliminal Quantel Medical, at one year in patients with refractory glaucoma.

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Since 1993, Quantel Medical develops, manufactures and markets innovative medical laser and ultrasound solutions.

World leader in ophthalmology, its lasers and ultrasounds are designed to diagnose and treat the four main causes of blindness: cataracts, glaucoma, diabetic retinopathy and macular degeneration; and also dry eye disease.

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