Download Beginner`s Technique with SLT

Beginner’s Technique with
SLT
Sungjun Hwang MD
Amy Zhang MD
Financial Disclosure: Hwang Gonio Lens (Ocular Instruments)
Purpose
Selective Laser Trabeculoplasty (SLT)
difficult for the novice given lack of burn
marks
Alternative method using a modified Latina
SLT Gonio Laser Lens (Ocular
Instruments)
Methods
161 SLT procedures
Private
comprehensive
practice
Reflected
Indicator
Modified Latina SLT
Gonio Laser lens
4 months follow-up
45o Indicator
Methods
Latina SLT Gonio
Laser Lens
-modified to indicate a
45o arc on the
trabecular meshwork
Laser applied to a 90o
arc using 45o
indicator as a guide
90o Arc
45o Indicator
Methods
Superior
Successively
positioned to treat 4
quadrants of each
eye
Superior, Temporal
inferior and nasal
quadrants of
trabecular meshwork
Inferior
Lateral
Lateral
Results
Average Pressure Difference -2.38 ±4.77
131 out of 161 eyes (81.4%) had reduction in
intraocular pressure (IOP)
43 eyes (26.7%) were able to reduce the usage
of IOP lowering medications
30 eyes (18.6%) did not experience any IOP
reduction
No adverse outcomes were noted
Conclusion
Argon Laser Trabeculoplasty (ALT) and
Selective Laser Trabeculoplasty (SLT) are
common modalities for treatment of glaucoma
with similar efficacies.1,2,3
ALT allows for visualization of the burn marks
thus facilitating placement of the next burn mark
especially for the novice.4,5
New technique with the modified lens allows
similar visualization on the SLT laser and yields
good results.
References
1. Shingleton BJ, Richter CU, Bellows AR,Hutchinson BT, Glynn RJ
Long-term efficacy of argon laser trabeculoplasty.Ophthalmolog1987 Dec;94(12):1513-8.
2.McIlraith I, Strasfeld M, Colev G, Hutnik CM Selective laser trabeculoplasty as initial
and adjunctive treatmentfor open-angle glaucoma. J Glaucoma. 2006 Apr;15(2):124-30.
3. Stein JD, Challa P.Mechanisms of action and efficacy of argon laser trabeculoplasty
and selective laser trabeculoplasty. Curr Opin Ophthalmol. 2007 Mar;18(2):140-5.
4. Pham H, Mansberger S, Brandt JD, Damji K, Ramulu PY, Parrish RK. Argon
Laser trabeculoplasty versus selective laser trabeculoplasty. Surv Ophthalmol. 2008 Nov
Dec;53(6):641-6.
5. Mahar PS, Jamali KK. Argon laser trabeculoplasty as primary therapy in open angle
glaucoma. J Coll Physicians Surg Pak. 2008 Feb;18(2):102-4.