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Micropulse laser trabeculoplasty: a gentler approach to re-establishing conventional outflow

Author(s):

Michael Giovingo

Giorgio Dorin

Catharine Thomas

Alexander Robin

John Samples

Thomas D. Patrianakos

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Abstract:

Initial treatment for patients with open-angle glaucoma typically consists of lowering the intraocular pressure (IOP) through the use of topical medication, laser trabeculoplasty (LT), or both. LT lowers IOP by increasing aqueous outflow through photostimulation of the trabecular meshwork (TM). A major benefit of LT over topical medications is that patient compliance is not a factor in treatment success. Argon laser trabeculoplasty (ALT), first described in 1979, has been shown to lower IOP as effectively as topical timolol but causes permanent damage to the TM, which can lead to long-term complications. Subsequently, selective laser trabeculoplasty (SLT) was developed as a minimally destructive alternative; however, postoperative inflammation and pressure spikes still occur with SLT at a non-negligible rate. Micropulse laser trabeculoplasty (MLT), first described in 2005, is a non-destructive alternative to previous types of LT. As a result of being a newer technology, studies into the efficacy and safety of MLT are still ongoing; however initial studies support MLT as being a safer and equally efficacious method for lowering IOP in comparison to previous forms of LT.

Glaucoma Research 2020-2022, pp. 193-200 #17
Edited by: Paul A. Knepper and John R. Samples
© Kugler Publications, Amsterdam, The Netherlands

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