Laser Treatment

Laser Treatment Options

OAG

The most common type of glaucoma, Open Angle Glaucoma (OAG), occurs when there is either a sustained increase in fluid production or a decrease in fluid drainage. With this imbalance in fluid flow, there is an increase in the intraocular pressure, which in turn reduces the blood flow in the sensitive tissues of the optic nerve.

Over time, as the optic nerve fibers are destroyed, peripheral (side) vision is lost.
Glaucoma has no symptoms, even while damage is being done, therefore early detection, through regular and complete eye exams, is the key to protecting your vision from damage caused by glaucoma.

OAG treatment concentrates on lowering the pressure inside the eye to prevent damage to the optic nerve. The most common treatments for glaucoma have been the use of medications in the form of eye drops or pills, as well as laser treatments. If these methods fail to decrease fluid pressure, surgery may be required to create a new drainage channel.

SLT/CPC

Selective Laser Trabeculoplasty

(SLT) is an advanced type of laser treatment to manage patients with Open Angle Glaucoma (OAG). SLT selectively stimulates or changes only specified pigmented cells to activate increased fluid drainage. Both the SLT and the older laser option, Argon Laser Trabeculoplasty (ALT), produce equivalent drops in Intra-Ocular Pressure (IOP), however, the more gentle SLT procedure does not have the associated damage to the other tissues and adverse scarring effects. For this reason, where ALT technology is limited, SLT may potentially be repeated if the IOP increases over time. SLT has also been found to be effective when ALT and other forms of treatment have failed.

Advantages of SLT

SLT is not associated with systemic side effects or the compliance and cost issues of medications.
SLT utilizes selective photothermolysis to target only specific cells, leaving the surrounding tissue intact with no adverse scarring of trabecular meshwork.
SLT therapy may reduce the need for lifelong use of expensive eye drops and other medications, minimizing out-of-pocket expenses.
SLT may be repeated if IOP gradually increases to unsafe levels.

SLT FAQs

HOW IS SLT PERFORMED?

SLT is an outpatient procedure. You will sit in a conventional exam chair, where the doctor will use a slit lamp, an ophthalmic microscope, to examine your eye. The same slit lamp contains the SLT laser. During the procedure, the doctor will put anesthetic drops in your eye to numb it, and then place a lens on your eye for better viewing. The entire procedure only takes a few moments.

HOW DOES SLT WORK?

SLT works by using laser light to stimulate the body’s own healing response to lower your eye pressure. Using a special wavelength and energy, the laser affects only specific cells of the eye – those containing melanin, a natural pigment. This allows for only these cells to be affected, leaving the surrounding tissue intact. SLT improves the flow of fluid in the eye, which in turn lowers your eye pressure.

HOW DO I KNOW SLT HAS WORKED?

There is no sensation associated with an SLT procedure. You will require follow-up visits with your doctor to monitor the success of the treatment.

The IOP should drop significantly in as little as a day or more of having SLT performed. It may take 6 to 8 weeks for the full effect of having SLT performed to be fully realized. The doctor may treat the eye with anti-inflammatory eye drops that will be continued for 4 to 7 days after the procedure. Most patients will have to return for follow-up visits to re-check the treated eye.

Unlike some glaucoma medications, there are no incidence of allergy or systemic side effects with SLT. Complications are minimal but may include inflammation, temporary increase in IOP, conjunctivitis, or eye pain.

For more information about Selective Laser Trabeculoplasty and how it may benefit you, please ask your doctor today.

Cyclophotocoagulation

(CPC) is an outpatient surgical procedure in which a laser is used to decrease pressure inside the eye (intraocular pressure). Two types of laser technology (transscleral cyclophotocoagulation and endoscopic cyclophotocoagulation) can be used in this procedure, with both working to alter the fluid-forming cells in the ciliary body (a structure located behind the iris) so they produce less aqueous humor (the clear fluid filling the space in the front of the eyeball between the lens and the cornea).

CPC FAQs

CAN I STOP MY GLAUCOMA DROPS AFTER CPC??

Because the effects of the treatment will not be known until a few weeks after the procedure, you may need to continue your eye drops for a while. Sometimes patients are able to reduce the number of eye drops they are taking. Even if you are taking the same glaucoma medications after the procedure, the laser is a success if your pressure is lower. The need for eye drops long-term after this treatment varies greatly and depends on your type of glaucoma and the rate at which it is progressing.

WHAT ARE SOME RISKS OF THE LASER SURGERY?

All laser procedures have some risks. The CPC treatment would not be offered by your doctor unless the potential benefits outweigh the potential risks. Risks include, but are not limited to, failure of treatment, pain, inflammation, loss of vision, development of eye pressure that is too low (hypotony), and unlikely but possible shrinkage of the eye. In general, serious risks are rare. You may want to discuss the benefits and risks with your eye doctor if you have further questions.

WILL CPC CURE MY GLAUCOMA?

No. Glaucoma is a chronic disease that requires constant monitoring and treatment. The CPC procedure will help to lower your eye pressure. However, it will not reverse any loss of vision that has already occurred.

DOES THE LASER PROCEDURE WORK FOR EVERYONE?

Unfortunately, the CPC procedure does not bring everyone’s pressure down into an acceptable range with one treatment. Multiple treatments may be needed. Alternative treatments may be discussed with your physician.