Abstract: Controlled, prospective, longitudinal, clinical trial with the objective to compare the efficacy of the micropulse laser trabeculoplasty (MLT) and the selective laser trabeculoplasty (SLT) in patients with open angle glaucoma or ocular hypertension. Patients were divided into two groups depending on the laser procedure, the group 1 was treated with SLT and the group 2 was treated with MLT; then they were followed for 3 months. 67 eyes were included in the trial (SLT: 38 eyes of 24 patients and MLT: 29 eyes of 19 patients). The average of age of the patients treated with SLT was 68.4 ± 8.8 years and with MLT 77.7 ± 7.3 years. The previous IOP was similar in both groups (SLT: 19.53 ± 4.03 mmHg, MLT: 19.76 ± 4.23 mmHg), a week after treatment (SLT: 18.53 ± 4.08 mmHg, MLT: 17.14 ± 5.19 mmHg), at month (SLT: 14.79 ± 2.42 mmHg, MLT: 16.26 ± 3.39 mmHg) and at 3 months (SLT: 15.66 ± 2.48 mmHg, MLT: 15.83 ± 3.19 mmHg). The percentage of IOP reduction was 19.81% with SLT and 19.89% with MLT. There was no statistically significant difference between the average IOP of both groups over 3 months of follow up. There was no difference in the number of drugs previous and posterior to the procedures, and there was not observed complications at any of the groups. The IOP-lowering effect of SLT and MLT was similar over 3 months in this group of patients and both proved to be safe procedures.
Products Featured: LIGHTLas SLT Deux, TruScan 577 with SP-Mode
AIM: Subthreshold lasers have gained popularity in the treatment of chorioretinopathy central serous chorioretinopathy (CSCR) and yellow (577 nm) lasers have completely revolutionized the treatment. However, there is very little literature regarding the use of a more common and conventional – green (532 nm) subthreshold laser for the treatment of chronic CSCR. We report the use of green (532 nm) laser for the treatment of chronic CSCR and its outcome.
Methods: Eyes with nonresolving CSCR were treated with green subthreshold laser and evaluated at the end of 5 months. Visual acuity, central macular thickness (CMT), and macular volume (MV) at baseline and at 5 months following treatment were evaluated.
Results: Thirteen eyes with chronic CSCR were treated with green laser in SP-Mode™. The mean duration of CSCR was 7.64±3.77 months at the time of treatment. The median age of the patients was 41 (35–57) years. The baseline mean best-corrected visual acuity (BCVA) was 0.96 logMAR ± 0.17, with mean baseline CMT of 503.8 µm ± 181.9 and MV of 12.8 mm3 ± 3.81. The mean CMT at 5 months was 211 µm ± 31.7 and mean MV was 9.65 mm3 ± 0.60, correlating to a mean decrease of 292 µm ± 79 in CMT and mean decrease of 3.18 mm3 ± 1.87 in the MV from baseline (P<0.05). The mean BCVA after treatment was 0.18 logMAR±0.09 (P<0.05). Two cases of CSCR with pigment epithelial detachment (PED) also had complete resolution of both at 5 months.
Conclusion: Subthreshold green laser (532 nm) is a safe and effective modality for the treatment of chronic CSCR with very good and stable outcomes. It may also be beneficial in the treatment of PEDs.
Products: LIGHTLas 532 with SP-Mode
“We described two young patients with persistent fovea detachment after scleral buckling for long-term retinal detachment."
Treatment: LIGHTLas Nd:YAG (LIGHTMED, USA) subretinal membranotomy was performed with a wavelength of 1064 nm, a pulse width of 4 ns, and a focal plan of up to 250 mm anteriorly. After mounting the Golmann contact lens (Haag-Streit, UK), the laser was applied to the thinner part of a band far from the macula. The end point of treatment was disruption of a band with total six pulses of 5.0 mJ/pulse. Nd:YAG laser produces photodisruption, and it can be applied in disorders of posterior segment including subhyaloid haemorrhage, diabetic tractional retinal detachment, preretinal macular fibrosis, and vitreoretinal traction from horseshoe tears.
Objective: To determine the anatomical and functional improvement in eyes with diffuse macular oedema after modified mild macular grid laser.
Methods: The prospective study was conducted at the Department of Ophthalmology Unit II, Civil Hospital Karachi, and the Department of Ophthalmology, Dow International Medical College, Karachi, from June 2011 to May 2014. We used neodymium-doped yttrium aluminium garnet 532nm frequency-doubled green laser to treat all eligible patients. Treatment variables were a spot size of 50 microns, exposure duration of 0.1 seconds, and power sufficient to produce barely visible burns in a grid pattern. We treated the thickened retina and non-thickened area of the macula excluding central 500 micron. Microaneurysms within the macular areas were treated by focal application of laser shots sufficient to bleach them.
Results: The study comprised 86 eyes of 52 patients who were treated by applying 180 to 360 burns with a mean of 275±51. Mean macular thickness differed significantly between time points (Wilks' Lambda 0.139; F (2, 6) = 125.95; p = 0.00001). Mean visual acuity changed significantly between time points (Wilks' Lambda 0.535; F (4, 82) = 17.8; p = 0.00001). At the last follow-up, visual acuity improved at least one line in 32(37.2%) eyes, remained stable in 48(55.8%) eyes, and declined in 6(6.9%) eyes.
Conclusion: Modified mild macular grid is an effective and safe procedure for patients with diffuse diabetic macular oedema.
Products Featured: LIGHTLas YAG/532 Combo System with SP-Mode