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Laser trabeculoplasty: Falling into disuse but still effective
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LAS VEGAS — In his experience, laser trabeculoplasty may be performed less and less, but is still effective in glaucoma management, according to John R. Samples, MD, of the Oregon Health and Sciences University in Portland.
“[Laser trabeculoplasty] does have it benefits. It can avoid the side effects that are possible with medication and there is no issue with noncompliance. It is particularly effective in some types of glaucoma and it can be repeated if there is a good initial response,” Dr. Samples, co-course director, said here at the First Annual Ocular Surgery News Symposium — Glaucoma: Improving Your Odds.
He noted that laser trabeculoplasty has fallen into relative disuse for a variety of reasons.
“Some say it is inconvenient but that may depend on the physical location of your laser. There is a perception that it is not effective; prostaglandins are on the scene and are effective pressure-lowering agents,” Dr. Samples said. Other reasons may be the tendency towards more frequent and earlier surgery and the cost of medications.
Since its development, several theories have emerged on how laser trabeculoplasty works. Mark Latina, MD, took his theory further by developing selective laser trabeculoplasty (SLT), which only treats pigmented cells.
“We think that SLT works the same as argon laser trabeculoplasty (ALT), but with the SLT there does not seem to be a lot of histologic damage to the meshwork,” Dr. Samples said. “We are still working out the theories of laser trabeculoplasty.”