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Proceedings Paper

Trans-scleral selective laser trabeculoplasty (SLT) without a gonioscopy lens (Conference Presentation)
Author(s): Michael Belkin; Noa Geffen; Modi Goldenfeld; Shay Ofir; Avner Belkin; Ehud Assia

Paper Abstract

Developing a one-second automatic glaucoma treatment using trans-scleral laser trabeculoplasty (LTP) without a gonioscopy lens Purpose: Developing an LTP device for delivering multiple simultaneous trans-scleral applications of low energy laser irradiation to the trabecular meshwork (TM) for reducing Intraocular Pressure (IOP). Methods: Concept proof: A randomized, masked, controlled one was performed on open angle glaucoma patients. The control group underwent conventional SLT (100 laser spots through a gonioscope for 360 degrees directly on the TM). The trial group underwent irradiation by the same laser at the same irradiation parameters on the sclera overlying the TM. Topical glaucoma therapy was not changed during the 12 months trial. Feasibility trial: Using optimized laser parameters, 60 discrete applications were administered on similar locations of patients’ sclera. Results: Concept proof: Trans-scleral applications: (N=15), IOP decrease from 20.21 mmHg before treatment to 16.00 (27.1%) at one year. The corresponding numbers for the control group (n=15), were 21.14 mmHg and 14.30 (23.4%). There was no statistical difference between the two groups in IOP reduction. The complications rate was significantly higher in the control group. Trial 2: IOP was reduced from an of 25.3 mmHg to 19.3 (23.7%) in the 11 patients. Conclusions: Laser coherency, lost in tissue transmission, is not required for the therapeutic effect. The new method will possibly enable treatment of angle closure glaucoma as well as simultaneous applications of all laser spots to the sclera. When used conjointly with target acquisition, will make feasible an automatic glaucoma treatment in less than one second.

Paper Details

Date Published: 26 April 2016
PDF: 1 pages
Proc. SPIE 9693, Ophthalmic Technologies XXVI, 969318 (26 April 2016); doi: 10.1117/12.2209093
Show Author Affiliations
Michael Belkin, Tel Aviv Univ. (Israel)
Noa Geffen, Meir Medical Ctr. (Israel)
Modi Goldenfeld, Sheba Medical Ctr. (Israel)
Shay Ofir, Meir Medical Ctr. (Israel)
Avner Belkin, Meir Medical Ctr. (Israel)
Ehud Assia, Meir Medical Ctr. (Israel)

Published in SPIE Proceedings Vol. 9693:
Ophthalmic Technologies XXVI
Fabrice Manns; Per G. Söderberg; Arthur Ho, Editor(s)

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