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    PSLT shows promise in lowering intraocular pressure

    Although similar in efficacy and safety to SLT, PSLT may offer advantages


    Laser advancements

    Selective laser trabeculoplasty (SLT) was introduced in the late 1990s1 as an alternative to argon laser trabeculoplasty. SLT uses a Q-switched, frequency-doubled 532-nm Nd:YAG laser to selectively target pigmented trabecular meshwork (TM) cells without damaging the TM or nonpigmented cells.

    SLT is repeatable. It has been demonstrated to be effective as primary treatment for POAG as well as an adjunct in early glaucoma treatment.4-6 Today, SLT is the most common form of laser treatment for IOP reduction.

    Pattern scanning laser trabeculoplasty or PSLT (Topcon) is a computer-guided pattern scanning laser system that provides rapid, tissue-sparing delivery of optically pumped semiconductor 577-nm laser treatment to the TM. The calculated alignment of the pattern ensures that the treatment spots do not overlap.

    Treatment is typically administered in 32 steps, each with three rows of evenly spaced laser spots, for 360º of the TM. The laser rotates the aiming beams automatically.

    An advantage of PSLT compared with SLT is that the former has a shorter treatment time. A 360º PSLT treatment generally takes approximately 3–5 minutes.

    Dr Mansouri and colleges recently conducted a randomised controlled trial comparing PSLT and SLT for IOP reduction in 58 eyes of 29 patients with primary and secondary OAG.7 Patients’ mean age was 54.1 ±15.5 years, and the baseline IOP was similar between the two groups (PSLT, 17.3 ±4.0 mm Hg; SLT, 16.8 ±3.6 mm Hg, P > 0.05).

    While IOP reduction was greater in the PSLT group than the SLT group at 1 month and 3 months, IOP levels were similar between the two treatment arms at 6 months (14.0 ±2.7 mmHg and 13.7 ±3.1 mmHg, respectively). Patients’ self-reported comfort level, however, was better for patients treated with PSLT than those treated with SLT.

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