Selective laser trabeculoplasty: current perspectives

Kate E Leahy,1 Andrew JR White1–3 1Westmead Hospital, Westmead, NSW, Australia; 2Centre for Vision Research, Westmead Millennium Institute, University of Sydney, Sydney, NSW, Australia; 3Save Sight Institute, University of Sydney, Sydney, NSW, Australia Abstract: Selective laser trabecul...

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Autores principales: Leahy KE, White AJR
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Lenguaje:EN
Publicado: Dove Medical Press 2015
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Acceso en línea:https://doaj.org/article/50507a3a3f2348548b6bb88c841bebd2
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spelling oai:doaj.org-article:50507a3a3f2348548b6bb88c841bebd22021-12-02T00:42:21ZSelective laser trabeculoplasty: current perspectives1177-5483https://doaj.org/article/50507a3a3f2348548b6bb88c841bebd22015-05-01T00:00:00Zhttp://www.dovepress.com/selective-laser-trabeculoplasty-current-perspectives-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Kate E Leahy,1 Andrew JR White1–3 1Westmead Hospital, Westmead, NSW, Australia; 2Centre for Vision Research, Westmead Millennium Institute, University of Sydney, Sydney, NSW, Australia; 3Save Sight Institute, University of Sydney, Sydney, NSW, Australia Abstract: Selective laser trabeculoplasty (SLT) has been used in the treatment of glaucoma for just over a decade. Here, we review the current literature in terms of suggested mechanism, efficacy, method of treatment, predictors of success, adverse events, repeatability, and cost of SLT. The exact mechanism by which SLT lowers intraocular pressure (IOP) remains unknown although circumstantial evidence has come in many forms in relation to structural alteration; oxidative stress and inflammatory responses; tight junction integrity; proliferative responses; and microbubble formation. SLT is as effective as argon laser trabeculoplasty and medications in reducing IOP in glaucoma and ocular hypertension. The treatment is not uniformly effective in all eyes, and its IOP-lowering effect decreases over time. High pretreatment IOP is the strongest predictor of success; however, significant pressure reduction has also been shown in normal-tension glaucoma and in patients already taking multiple antiglaucoma drops. Mild, transient adverse effects are common. Transient IOP spikes usually resolve quickly with or without antiglaucoma treatment but may be problematic in pigmented angles. The limited available evidence suggests SLT is repeatable and cost-effective for the treatment of glaucoma and ocular hypertension. Keywords: glaucoma, SLT, ocular hypertension, intraocular pressureLeahy KEWhite AJRDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2015, Iss default, Pp 833-841 (2015)
institution DOAJ
collection DOAJ
language EN
topic Ophthalmology
RE1-994
spellingShingle Ophthalmology
RE1-994
Leahy KE
White AJR
Selective laser trabeculoplasty: current perspectives
description Kate E Leahy,1 Andrew JR White1–3 1Westmead Hospital, Westmead, NSW, Australia; 2Centre for Vision Research, Westmead Millennium Institute, University of Sydney, Sydney, NSW, Australia; 3Save Sight Institute, University of Sydney, Sydney, NSW, Australia Abstract: Selective laser trabeculoplasty (SLT) has been used in the treatment of glaucoma for just over a decade. Here, we review the current literature in terms of suggested mechanism, efficacy, method of treatment, predictors of success, adverse events, repeatability, and cost of SLT. The exact mechanism by which SLT lowers intraocular pressure (IOP) remains unknown although circumstantial evidence has come in many forms in relation to structural alteration; oxidative stress and inflammatory responses; tight junction integrity; proliferative responses; and microbubble formation. SLT is as effective as argon laser trabeculoplasty and medications in reducing IOP in glaucoma and ocular hypertension. The treatment is not uniformly effective in all eyes, and its IOP-lowering effect decreases over time. High pretreatment IOP is the strongest predictor of success; however, significant pressure reduction has also been shown in normal-tension glaucoma and in patients already taking multiple antiglaucoma drops. Mild, transient adverse effects are common. Transient IOP spikes usually resolve quickly with or without antiglaucoma treatment but may be problematic in pigmented angles. The limited available evidence suggests SLT is repeatable and cost-effective for the treatment of glaucoma and ocular hypertension. Keywords: glaucoma, SLT, ocular hypertension, intraocular pressure
format article
author Leahy KE
White AJR
author_facet Leahy KE
White AJR
author_sort Leahy KE
title Selective laser trabeculoplasty: current perspectives
title_short Selective laser trabeculoplasty: current perspectives
title_full Selective laser trabeculoplasty: current perspectives
title_fullStr Selective laser trabeculoplasty: current perspectives
title_full_unstemmed Selective laser trabeculoplasty: current perspectives
title_sort selective laser trabeculoplasty: current perspectives
publisher Dove Medical Press
publishDate 2015
url https://doaj.org/article/50507a3a3f2348548b6bb88c841bebd2
work_keys_str_mv AT leahyke selectivelasertrabeculoplastycurrentperspectives
AT whiteajr selectivelasertrabeculoplastycurrentperspectives
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