Thursday, November 23, 2006

An Update on the Use of SLT for Treating Glaucoma

An Update on the Use of SLT for Treating Glaucoma

I have previously written about the use of lasers, including SLT, to treat glaucoma. (See the references at the end of this report.) Michael Lachman of Lachman Consulting LLC wrote about the use of SLT becoming a first-line treatment for glaucoma, as I have previously predicted, in his recent report from the 2006 AAO meeting held in Las Vegas (EyeQ Report No. 9). With his permission, here is what he wrote.

SLT Steps Up its Challenge to Eye Drops as First-Line Therapy for Glaucoma

Our discussions in recent months with ophthalmologists from a variety of sub-specialties indicate that selective laser trabeculoplasty (SLT) is increasingly becoming a first-line alternative for glaucoma patients. SLT, which utilizes the Selecta II laser manufactured by Lumenis, was introduced in the US about five years ago. The company says that there are over 1,000 of its lasers currently in use for SLT in the US. SLT reduces IOP by improving aqueous outflow without the coagulative damage to the trabecular meshwork caused by argon laser trabeculoplasty (ALT). Because of the high cost, potential side effects, and well-documented compliance issues associated with glaucoma medications, ophthalmologists are increasingly offering SLT to their patients prior to prescribing eye drops.

At the scientific poster session, L. Jay Katz, MD presented results from the first multicenter study comparing SLT with medical monotherapy using prostaglandins. The prospective, randomized, controlled trial covered 136 eyes of 72 patients, treated at 17 sites. At the 8 month follow-up interval, IOP reduction was comparable in the medication and SLT groups. The medical therapy cohort had mean IOP reduction from 25.0 to 17.3mmHg (-31%), and the SLT cohort had mean IOP reduction from 24.7 to 18.0mmHg (-27%). A majority of patients in each arm of the study was within 2mmHg of target IOP. Q

Additional References on Treatments, including SLT, for Glaucoma:

SLT: New Treatment for Glaucoma Becomes Available; Ocular Surgery News, May 15, 2001.

Advances in the Treatment of Glaucoma; Optistock Industry Overview, Fall 2001.


At 5:41 PM, Anonymous Anonymous said...

I would be interested in knowing how safe the SLT procedure is, how many cases should the operator have done for him-her to be competent. I was put on Travatan 4 weeks ago and had to stop after 10 days, Flu like symptoms,headache,cough, just getting rid of the sinus problems now, terrible congestion. Haven't been back to VA since, when I go back I'm going to ask for the SLT since I won't take any of those medications.

At 2:26 PM, Anonymous Anonymous said...

I believe the risk from glaucoma meds is far greater than the risks from an slt procedure. I've performed thousands since 2001. I've never had anyone experience blurring for more than a couple of days, nor pain lasting more than a few days. I have had many pt.s experience severe allergic reactions to the glaucoma meds as well as breathing problems and other side effects as well.


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