Complications of selective laser trabeculoplasty: a review

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Selective laser trabeculoplasty is a laser treatment to treat glaucoma. It was initially indicated for open-angle glaucoma but has been proven to be efficacious for various types of glaucoma. This review article summarizes the few rare complications that can be seen with selective laser trabeculoplasty. It also makes recommendations on how to avoid these problems and how to treat patients when these rare complications arise.

Video abstract

Related collections

Most cited references 62

Record: found
Abstract: found
Article: not found

Q-switched 532-nm Nd:YAG laser trabeculoplasty (selective laser trabeculoplasty): a multicenter, pilot, clinical study.

S Sibayan, R Noecker, G Marcellino … (1998)

To investigate the safety and efficacy of a new laser procedure using a q-switched 532-nm neodymium (Nd):YAG laser, also called "selective laser trabeculoplasty," to lower intraocular pressure (IOP) in patients with open-angle glaucoma (OAG). The laser parameters were set to selectively target pigmented trabecular meshwork (TM) cells without coagulative damage to the TM structure or nonpigmented cells. Nonrandomized, prospective, clinical trial. Thirty eyes of 30 patients with uncontrolled OAG (OAG group) and 23 eyes of 23 patients with uncontrolled OAG treated previously with argon laser trabeculoplasty (ALT group) were observed for 4 to 26 weeks. Forty-four of the 53 eyes were observed for 26 weeks. Patients were treated with the Coherent Selecta 7000 (Coherent, Inc, Palo Alto, CA) frequency-doubled q-switched Nd:YAG laser (532 nm). A total of approximately 50 nonoverlapping spots were placed over 180 degrees of the TM at energy levels ranging from 0.6 to 1.2 mJ per pulse. After surgery, patients were maintained with the identical drug regimen as that before treatment. Both the OAG and ALT groups showed similar IOP reductions over time. Seventy percent of patients in each group responded to treatment with an IOP reduction of least 3 mmHg. At 26 weeks of follow-up, mean IOP reduction was 5.8 mmHg (23.5%, P < 0.001) for the OAG group and 6.0 mmHg (24.2%, P < 0.001) for the ALT group. The untreated eye showed a 9.7% (P < 0.001) reduction of IOP at 26 weeks. However, the IOP difference between the treated and untreated eyes was statistically significant at P < 0.003. Transient IOP elevation of 5 mmHg or greater was seen in 24% of patients. The selective laser trabeculoplasty appears to be a safe and effective method to lower IOP in patients with OAG and patients treated previously with ALT. A reduction of IOP can be achieved without coagulation of the TM.

0 comments Cited 89 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Selective targeting of trabecular meshwork cells: in vitro studies of pulsed and CW laser interactions.

Jacqueline Latina, I. C. Park (1995)

The purpose of the present study was to selectively target pigmented trabecular meshwork cells without producing collateral damage to adjacent non-pigmented cells or structures. The ability to selectively target trabecular meshwork cells without coagulation, while preserving the structural integrity of the meshwork, could be a useful approach to study whether the biological response of non-coagulative damage to the trabecular meshwork and trabecular meshwork cells is similar to that seen with coagulative damage to the trabecular meshwork which occurs with argon laser trabeculoplasty. This approach also may be useful to non-invasively deplete trabecular meshwork cells while preserving the structural integrity of the trabecular meshwork in an animal model. A mixed cell culture of pigmented and non-pigmented trabecular meshwork cells were irradiated with Q-switched Nd-YAG and frequency-doubled Nd-YAG lasers, microsound pulsed dye-lasers, and an argon ion laser in order to define a regime where laser absorption would be confined to pigmented trabecular meshwork cells, thereby permitting selective targeting of these cells without producing collateral thermal damage to adjacent non-pigmented cells. Pulse durations ranged from 10 nsec to 0.1 sec. A fluorescent viability/cytotoxicity assay was used to evaluate laser effects and threshold energies, and cells were examined morphologically by light and TEM. Selective targeting of pigmented trabecular meshwork cells was achieved with pulse durations between 10 nsec and 1 microsec and 1 microsec without producing collateral thermal or structural damage to adjacent non-pigmented trabecular meshworks cells when examined by light and transmission electron microscopy. Pulse durations greater than 1 microsec resulted in non-selective killing of non-pigmented trabecular meshwork cells. Threshold radiant exposures were as low as 18 mJ cm-2, and increased at longer wavelengths, longer pulse durations and lower melanin contents within the cells. It is concluded that selective targeting of pigmented trabecular meshwork cells can be achieved using pulsed lasers with low threshold radiant exposures avoiding collateral thermal damage to adjacent non-pigmented trabecular meshwork cells. This approach can be readily applied in vivo.

0 comments Cited 78 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Comparison of the morphologic changes after selective laser trabeculoplasty and argon laser trabeculoplasty in human eye bank eyes.

Theresa R. Kramer, Robert J Noecker (2001)

To compare the histopathologic changes in the human trabecular meshwork (TM) after argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT) with a Q-switched, frequency-doubled, neodymium:yttrium-aluminum-garnet laser. Human "in vitro" experimental study. TISSUE AND CONTROLS: Eight human autopsy eyes were obtained within 18 hours of death from persons aged 71 to 78 years. The anterior segment of autopsy eyes was isolated, and one half of each trabecular meshwork underwent SLT and the other half ALT. Specimens were evaluated with scanning and transmission electron microscopy. Structural changes in the TM were detected by scanning electron microscopy, and cellular or intracellular changes were seen with transmission electron microscopy. Evaluation of the TM after ALT revealed crater formation in the uveal meshwork at the junction of the pigmented and nonpigmented TM. Coagulative damage was evident at the base and along the edge of craters, with disruption of the collagen beams, fibrinous exudate, lysis of endothelial cells, and nuclear and cytoplasmic debris. Evaluation of the TM after SLT revealed no evidence of coagulative damage or disruption of the corneoscleral or uveal trabecular beam structure. Minimal evidence of mechanical damage was present after SLT, and the only ultrastructural evidence of laser tissue interaction was cracking of intracytoplasmic pigment granules and disruption of trabecular endothelial cells. SLT applied "in vitro" to the TM of human eye bank eyes seemed to cause no coagulative damage and less structural damage to the human TM when compared with ALT and, therefore, may be a safer and more repeatable procedure.

0 comments Cited 66 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): Clin Ophthalmol

Journal ID (iso-abbrev): Clin Ophthalmol

Journal ID (publisher-id): Clinical Ophthalmology

Title: Clinical Ophthalmology (Auckland, N.Z.)

Publisher: Dove Medical Press

ISSN (Print): 1177-5467

ISSN (Electronic): 1177-5483

Publication date Collection: 2016

Publication date (Electronic): 14 January 2016

Volume: 10

Pages: 137-143

Affiliations

Ophthalmology, Long Beach Memorial Medical Center, Long Beach, CA, USA

Author notes

Correspondence: Julia Song, Ophthalmology, Long Beach Memorial Medical Center, 2840 Long Beach Boulevard, #330, Long Beach, CA 90806, USA, Tel +1 562 427 0700, Fax +1 562 427 2525, Email jsongmd@ 123456drsongvision.com

Article

Publisher ID: opth-10-137

DOI: 10.2147/OPTH.S84996

PMC ID: 4716769

PubMed ID: 26834456

SO-VID: 3bf9419e-0b67-4ad4-8719-490f63276fcf

License:

The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

Complications of selective laser trabeculoplasty: a review

Read this article at

Abstract

Video abstract

Related collections

Karger: Ophthalmology

Most cited references 62

Q-switched 532-nm Nd:YAG laser trabeculoplasty (selective laser trabeculoplasty): a multicenter, pilot, clinical study.

Selective targeting of trabecular meshwork cells: in vitro studies of pulsed and CW laser interactions.

Comparison of the morphologic changes after selective laser trabeculoplasty and argon laser trabeculoplasty in human eye bank eyes.

Author and article information

Journal

Affiliations

Author notes

Article

History

Categories

Comments

Comment on this article

Similar content 578

Cited by 23

Most referenced authors 373