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Dr. Mark Tomalla
Dr. Prateep Vyas
Dr. Prashant N. Vasa
Dr. Prin RojanaPongpun
Dr. David Gosiengfiao
Dr. Enping Chen
Dr. Ivan Goldberg
Ms. Madhu Nagar
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| Clinical Tips by:
Jens Funk, PhD, MD, and Frau Cornelia Hirn, MD, University Hospital Zurich, Switzerland
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| We utilize the laser for classic SLT indications: mainly on patients that require an additional lowering of intraocular pressure of approximately 4 mmHg in order to achieve target IOP. |
| We believe that thorough and open patient education is very important prior to the SLT treatment. We emphasize that the treatment is harmless and not painful. We also explain that the illumination used during the procedure may temporarily glare the eye, so that the patient may not be able to see for approximately 30 minutes after the treatment. In addition, the use of a contact lens may cause a slight irritation and reddening of the eye after the procedure. |
| One hour prior to SLT treatment we administer Alphagan. |
| During the treatment we gradually increase the energy until we see the typical champagne bubbles. Once we have reached that point, we slightly reduce the energy to treat just below the threshold for bubble formation. We also consider the level of pigmentation. The treatment is circular, and we normally treat the full 360 degrees at once. |
| Overall, the treatment is very short and does not take longer than 10 minutes. |
| We observe IOP spikes post-operatively in more than 10 percent of patients (increase was less than 10 mmHg). In those cases we administered Diamox, which showed a good and quick response. Intraocular pressure was lowered sufficiently within 24 hours. So even in the event of a paradox IOP spike, it can be controlled very well. |
| In some patients, we observed a slight irritation of the anterior chamber; however, we did not have to treat those with medication. Hence we do not use anti-inflammatory medications, and consider them unnecessary. No patient has experienced a deterioration in vision to this day. |
| We make it very clear to our patients that they must continue to take their glaucoma medication postoperatively. This is especially important since the effect of SLT may have a delayed onset, and needs to be monitored for some time while the original medical therapy is continued. After six months, we assess whether we can stop the medication altogether (in our study, we already had one patient for whom medication was not necessary six months after SLT treatment). |
| Our conclusion: SLT in an effective, easy treatment with very low side effects. Even new users can achieve the same good results that have been reported in the literature. |
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CLINICAL TIPS - PRASHANT N. VASA
