Glaucoma Treatment Options

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Selective Laser Trabeculoplasty (SLT)
Glaucoma Laser Surgery

Laser surgery has become increasingly popular as an intermediate step between medications and traditional glaucoma filtration surgery. Selective Laser Trabeculoplasty (SLT) is a relatively new laser treatment for open-angle glaucoma.

SLT uses short pulses of low energy laser light to target melanin-containing cells in a network of tiny channels, called the trabecular meshwork. The objective of the surgery is to help fluids drain out of the eye, reducing intra-ocular pressure that can cause damage to the optic nerve and loss of vision.

The selective technique is much less traumatic to the eye than Argon Laser Trabeculoplasty (ALT), which has been the standard laser procedure. ALT can cause tissue destruction and scarring of healthy cells in the trabecular meshwork structure. SLT reduces intra-ocular pressure without this risk. SLT can be used to effectively treat some patients who could not benefit from ALT. This includes patients who have already been treated with ALT.

Although your doctor may suggest laser surgery at any time, it is often performed after trying to control intra-ocular pressure with medicines. In many cases, you will need to keep taking glaucoma drugs even after laser surgery.

SLT is for those:

  • who have been diagnosed with glaucoma
  • whose doctor has determined that SLT is appropriate for controlling their intra-ocular pressure

Argon Laser Trabeculoplasty (ALT) Glaucoma Surgery

The objective of ALT surgery is to help fluids drain out of the eye, reducing intra-ocular pressure that can cause damage to the optic nerve and loss of vision.

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Although our eye care professional may suggest ALT surgery at any time, it is often performed after trying to control intra-ocular pressure with medicines. In many cases, you will need to keep taking glaucoma medications even after ALT surgery.

ALT is for those:

  • who have been diagnosed with glaucoma
  • whose doctor has determined that ALT is appropriate for controlling their intra-ocular pressure

Laser Iridotomy – Narrow Angle Glaucoma Surgery

Laser iridotomy is a treatment for narrow-angle glaucoma. In laser iridotomy, a small hole is placed in the iris to create a hole for fluid to drain from the back of the eye to the front of the eye. Without this new channel through the iris, intra-ocular pressure can build rapidly causing damage to the delicate optic nerve, and permanent loss of vision. In most patients, the iridotomy is placed in the upper portion of the iris, under the upper eyelid, where it cannot be seen.

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The purpose of an iridotomy is to preserve vision, not to improve it.A small hole is placed in the iris to create a hole for fluid to drain from the back of the eye to the front of the eye.

Laser Iridotomy is for those:

  • who have been diagnosed with narrow-angle glaucoma.
  • whose doctor has determined that laser iridotomy is the appropriate treatment for their condition.

Filtration Surgery (Trabeculectomy)

Filtration surgery, also called trabeculectomy surgery, is a treatment for several types of glaucoma including open-angle and narrow-angle glaucoma. It is often performed on patients who have not responded well to medication or laser treatment such as ALT or SLT. Filtration surgery usually provides a dramatic reduction in pressure within the eye.

Filtration surgery is for those:

  • who have been diagnosed with glaucoma
  • whose doctor has determined that filtration surgery is an appropriate treatment for their condition

Endoscopic CycloPhotocoagulation (ECP)

Endoscopic CycloPhotocoagulation or ECP, is an exciting development in the management of many types of glaucoma including the more common open-angle glaucoma and narrow-angle glaucoma. ECP is performed on an outpatient basis. In this procedure, the ciliary body of the eye, which creates fluid, is treated with a laser. This reduces fluid production that in turn, reduces intra-ocular pressure. The ciliary body is a small gland running around the circumference of the eye located behind the iris.

The ciliary body of the eye, which creates fluid, is treated with a laser.

ECP allows the surgeon to view the area through an endoscopic camera, which aids in the very precise placement of the laser beam used for treatment.

Endoscopic CycloPhotocoagulation is often performed on patients at the time of cataract surgery. It can also be performed on those patients who had SLT or ALT laser procedures, glaucoma filtration surgery or other surgical procedures that were not successful at controlling intra-ocular pressure.

ECP has proven to be an effective way to reduce intra-ocular pressure. Studies have shown that the majority of patients have their glaucoma medications reduced or completely eliminated after the procedure and are no longer at risk of loss of vision from glaucoma.

Endoscopic CycloPhotocoagulation is for those who:

  • have glaucoma or higher than normal intra-ocular pressure including those with cataracts
  • have not responded well to medications and other surgical to other treatments