Laser eye surgery (before and after) | SLT laser surgery
Its technical name is Selective Laser Trabeculoplasty. SLT laser therapy is a painless, minimally invasive procedure that provides several benefits over conventional treatment for glaucoma.
SLT glaucoma laser surgery success rate is typically up to 85% & the least complex types of laser eye surgery, but unlike other glaucoma surgery, precautions and glaucoma after care dos and don'ts don't apply after SLT laser eye surgery, unless specified by the ophthalmologist or optometrist. However, all laser surgery for glaucoma has potential side effects, but the benefits of maintaining good eyesight heavily outweigh any risk of surgery problems. In this story I'll tell you how up until 48 hours after my laser eye surgery, the pupil of my eye remained very small until the procedure had sufficient recovery time. Blurred vision could be one of a number of side effects you may or may not experience (see data & links below). It's prudent to check prior to SLT or other laser therapy, any cost that may be incurred with laser eye surgery, or if it will be covered by medicare.
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Useful info about eye disease glaucoma & SLT laser surgery;
https://www.glaucoma.org/treatment/selective-laser-trabeculoplasty-10-commonly-asked-questions.php
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4716769/
Selective laser trabeculoplasty is a laser treatment to treat glaucoma. It was initially indicated for open-angle glaucoma but has been proven to be efficacious for various types of glaucoma. This review article summarizes the few rare complications that can be seen with selective laser trabeculoplasty.
Glaucoma is an optic neuropathy in which intraocular pressures (IOPs) that are too high for the eye can result in optic nerve damage, subsequently leading to peripheral or central visual field loss. Modes of treatment include medications, laser, or intraocular surgery.
Selective laser trabeculoplasty (SLT) was developed in 1999 by Latina and Park2 as an alternative to ALT. SLT is a laser treatment that can reduce IOP in patients with open-angle glaucoma (OAG). SLT has a very short pulse duration (3 ns), which is shorter than the thermal relaxation time of melanin, allowing for selective photothermolysis. Because SLT selectively targets the pigmented TM cells and has an energy level 1% of ALT, it is a gentler laser than ALT with no histologic scarring or coagulative damage to the TM,3,4 thus reducing collateral damage to surrounding tissues and making repeat treatments possible. The incidence of iritis and elevated IOP is much lower compared to ALT.5
Indications
SLT has a variable success rate (40%–70%) in adults.6–8 SLT has been shown to be safe in adults,9 and the complication rate is extremely low.
Mechanism of action
The mechanism of action of SLT is not fully understood, although it is believed that it is more cellular and less mechanical or thermal,22 with macrophages from the spleen recruited into the TM via cytokines to remove debris from the TM.23 Histological studies have demonstrated minimal coagulative or mechanical damage.3,22,24 The TM following SLT was intact except for cracks in the corneoscleral sheets and a few endothelial cells with disrupted intracytoplasmic pigment granules and vacuoles.3,24 There is also evidence of TM cell division following both ALT and SLT.25,26
There is controversy whether SLT efficacy decreases with the use of concomitant prostaglandins. One study27 reported a 7% drop in IOP vs 20% drop in IOP when not taking prostaglandins. Another study28found that the success rate of SLT was 78.6% at 1 year in patients who were on combined dorzolamide–timolol and only 50% in patients who were on prostaglandins (P=0.041). Schlemm canal cells exposed to media conditioned by L cells that had been exposed to SLT or prostaglandin analogs demonstrated similar cell junction disassembly, whereas the cells exposed to nonprostaglandin analogs (brimonidine, timolol, and dorzolamide) did not show cell junction disassembly.29 This implies a similar mechanism of action between prostaglandins and SLT. The poorer success of SLT in patients on prostaglandins may suggest similar mechanisms of action of SLT and prostaglandins and that these two treatment methods may compete with one another. ALT use declined with the advent of prostaglandins for glaucoma therapy. Perhaps the decline in ALT efficacy in the 1990s was due to the minimal efficacy as a result of competition between prostaglandins and ALT (since they both share the same mechanism of action).
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