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Back to Clinical Tips
Previous Tips:
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:
MS. MADHU NAGAR, FRCS OPHTH, MS OPHTH
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| Titrate energy over moderately pigmented trabecular meshwork. |
| Determine the most effective energy level by using the lowest energy level that produces a small puff of pigment or causes champagne bubble formation. This depends on the amount of trabecular pigmentation, but usually ranges between 0.6 – 1.2 mJ on average. |
| We tend to be overcautious when treating our first few patients and do not use sufficient energy or sufficient number of spots, which then gives disappointing or discouraging results. |
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Use G.Pilocarpine prior to SLT treatment if angle appears narrow - grade 2-3. |
Prescribe non-steroidal anti-inflammatory drops rather than steroids post-SLT treatment. |
| Check IOP one hour post SLT or treat post-SLT with Apraclonidine or Brimonidine drops. |
| Treat pigmentary glaucoma cases in two sessions rather than one if you decide to perform 360 degrees, to avoid the risk of a post-SLT IOP spike. |
| Pre-treat patients that have substantial field loss with Apraclonidine drops and Tab Diamox 250mgs stat dose. |
| Watch out for slow or late responders. IOP reduction is usually observed on day one, but 8-10 percent patients respond between 4-12 weeks post treatment. |
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Adjunctive Rx – try to wash off medications prior to SLT. |
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CLINICAL TIPS - MS. MADHU NAGAR
