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Beginner’s Technique with SLT

Beginner’s Technique with SLT. Sungjun Hwang MD Amy Zhang MD. Financial Disclosure: Hwang Gonio Lens (Ocular Instruments). Purpose. Selective Laser Trabeculoplasty (SLT) difficult for the novice given lack of burn marks

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Beginner’s Technique with SLT

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  1. Beginner’s Technique with SLT Sungjun Hwang MD Amy Zhang MD Financial Disclosure: Hwang Gonio Lens (Ocular Instruments)

  2. Purpose • Selective Laser Trabeculoplasty (SLT) difficult for the novice given lack of burn marks • Alternative method using a modified Latina SLT Gonio Laser Lens (Ocular Instruments)

  3. Methods • 161 SLT procedures • Private comprehensive practice • Modified Latina SLT Gonio Laser lens • 4 months follow-up Reflected Indicator 45o Indicator

  4. Methods • Latina SLT Gonio Laser Lens -modified to indicate a 45o arc on the trabecular meshwork • Laser applied to a 90o arc using 45o indicator as a guide 90o Arc 45o Indicator

  5. Methods Lateral Superior • Successively positioned to treat 4 quadrants of each eye • Superior, Temporal inferior and nasal quadrants of trabecular meshwork Inferior Lateral

  6. Results • Average Pressure Difference -2.38 ±4.77 • 131 out of 161 eyes (81.4%) had reduction in intraocular pressure (IOP) • 43 eyes (26.7%) were able to reduce the usage of IOP lowering medications • 30 eyes (18.6%) did not experience any IOP reduction • No adverse outcomes were noted

  7. Conclusion • Argon Laser Trabeculoplasty (ALT) and Selective Laser Trabeculoplasty (SLT) are common modalities for treatment of glaucoma with similar efficacies.1,2,3 • ALT allows for visualization of the burn marks thus facilitating placement of the next burn mark especially for the novice.4,5 • New technique with the modified lens allows similar visualization on the SLT laser and yields good results.

  8. References 1. Shingleton BJ, Richter CU, Bellows AR,Hutchinson BT, Glynn RJ Long-term efficacy of argon laser trabeculoplasty.Ophthalmolog1987 Dec;94(12):1513-8. 2.McIlraith I, Strasfeld M, Colev G, Hutnik CM Selective laser trabeculoplasty as initial and adjunctive treatmentfor open-angle glaucoma. J Glaucoma. 2006 Apr;15(2):124-30. 3. Stein JD, Challa P.Mechanisms of action and efficacy of argon laser trabeculoplasty and selective laser trabeculoplasty. Curr Opin Ophthalmol. 2007 Mar;18(2):140-5. 4. Pham H, Mansberger S, Brandt JD, Damji K, Ramulu PY, Parrish RK. Argon Laser trabeculoplasty versus selective laser trabeculoplasty. Surv Ophthalmol. 2008 Nov Dec;53(6):641-6. 5. Mahar PS, Jamali KK. Argon laser trabeculoplasty as primary therapy in open angle glaucoma. J Coll Physicians Surg Pak. 2008 Feb;18(2):102-4.

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