Selective laser trabeculoplasty as the primary treatment for open angle glaucoma: time for change?

Ang, Marcus; Tham, Clement C.; Sng, Chelvin C. A.

doi:10.1038/s41433-019-0625-6

Cited by 6 publications

(4 citation statements)

References 21 publications

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“…A prospective study showed that MLT managed to reduce IOP by 20% at 12 months in 75% of patients [108]. Several studies have demonstrated comparable results between ALT, SLT and MLT [108,110,112,113]. Titanium-sapphire laser trabeculoplasty (TSLT) is a subtype of laser trabeculoplasty emitting near-infrared energy in pulses of 5-10 ms, which allows deeper penetration into the juxtacanalicular meshwork and selective absorption by phagocytic cells, in order to prevent damage to the rest of the trabecular meshwork.…”

Section: Lasermentioning

confidence: 99%

“…With the advent of selective laser trabeculoplasty (SLT) the number of laser procedures has dramatically increased since the early 2000s [108,113]: SLT achieves similar results to ALT but, with a shorter duration and lower power, it has less traumatic effects on the trabecular meshwork, because it selectively targets the pigmented cells while sparing adjacent cells [112].…”

Section: Lasermentioning

confidence: 99%

“…It is effective at lowering the IOP and can be used in early treatment for patients not compliant to glaucoma medications, either as primary treatment or in addition to medical therapy [113]. The LiGHT trial is a multicentre randomised controlled trial aimed at comparing the benefits of using either SLT (followed by medical therapy when necessary) or standard medications as first-line treatment for open-angle glaucoma and ocular hypertension and demonstrated the cost-effectiveness of SLT and the slightly better clinical outcomes, suggesting it as an alternative to topical drops.…”

Section: Lasermentioning

confidence: 99%

“…Micropulse laser trabeculoplasty (MLT) is one of the newer types of laser developed, that delivers repetitive microsecond pulses of energy followed by intermittent periods of rest, so that it prevents accumulation of thermal energy [108,110,112,113]. MLT does not cause mechanical damage and scarring to the trabecular meshwork, but it induces a cascade of cytokines and interleukins that reduces tissue damage and increases aqueous outflow.…”

Section: Lasermentioning

confidence: 99%

See 3 more Smart Citations

Personalized approaches for the management of glaucoma

Balendra

Zollet

Casasca

et al. 2020

Expert Review of Precision Medicine and Drug Development

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Introduction: Personalised medicine is the future goal across all specialities. Accurate prediction of optimal treatment beneficial and adverse effects could transform patient management. This is of particular importance in chronic conditions, where a 'trial and error' approach over months and years can contribute to significant morbidity. Glaucoma is a chronic irreversible progressive optic neuropathy, a leading cause of blindness worldwide. An ideal personalised approach in glaucoma clinic would be to answer the inevitable question in a patient's first visit: 'Which treatment option will work best for me so that I won't go blind?' Areas covered: This review will give an overview of the knowledge we have acquired to achieve this goal, particularly discussing using patient's individual risk factors, their genetic profile and different treatment modalities, including therapy compliance, to personalise care. Expert opinion: Pharmacogenomics and genetic profiling are the most tangible ways in which glaucoma management can be personalised. Future challenges will include developing realistic animal models to reflect the underlying genetic patterns in glaucoma that to investigate their interaction with different treatments.

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