Excimer laser trabeculostomy (ELT): the laserbased MIGS procedure for open-angle glaucoma


Michael Berlin

Marc Toteberg-Harms

Jonathan Shakibkhou

Alyssa Francesca Ahorro

Ryan Lamrani

Ulrich Giers

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This book chapter introduces and discusses excimer laser trabeculostomy (ELT), the laser-based microinvasive glaucoma surgery (MIGS) procedure for open-angle glaucoma. Differing from other MIGS procedures, all of which involve insertion of stents or other materials, ELT utilizes an essentially nonthermal photoablative laser which removes tissue without scar or healing to enable the creation of outflow obstruction bypass channels between the anterior chamber and Schlemm’s canal. The long-term patency of these channels enables stent equivalent outflow without stents. ELT can be performed as a standalone procedure or simultaneously with cataract surgery. Further, the ELT procedure has the longest documented MIGS postoperative study data, which verifies its safety and efficacy in long-term lowering of both intraocular pressure and antiglaucoma medications. The next generation of ELT devices, called Guided ELT, are currently under development to enable the first goniolens-free, angle-based MIGS procedure by providing real-time virtual image guidance to the surgeon.

New Concepts in Glaucoma Surgery Series: Volume 1, pp. 231-244 #16
Edited by: John R. Samples and Iqbal Ike K. Ahmed
© Kugler Publications, Amsterdam, The Netherlands

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Kugler Publications

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