Selective Laser Trabeculoplasty
Selective Laser Trabeculoplasty (SLT) May Prevent High Intraocular Pressure after Intravitreal Corticosteroid Injection
Selective Laser Trabeculoplasty (SLT) can be used in patients with Steroid Induced Glaucoma to prevent the elevation of intraocular pressure after Intravitreal injection of corticosteroid.
Steroid Induced Glaucoma is type of open angle glaucoma that occurs with the use of corticosteroid (as an eye drops or as an Intravitreal injection). High intraocular pressure can be temporary and most of time these patients require anti-glaucoma medications.
Macular edema occurs when there are damaged retinal blood vessels that leak fluid into the macular area of the retina. Treatments of macular edema include laser photocoagulation, Intravitreal injections of Anti-VEGF, Intravitreal injection of corticosteroid and Vitrectomy surgery.
There are many causes of macular edema such as Diabetic Retinopathy, Retinal Vein Occlusions, Post Cataract Surgery and Age-Related Macular Degeneration with Macular Edema.
Selective Laser Trabeculoplasty (SLT) is a safe and effective treatment to lower the intraocular pressure in patients with open angle glaucoma. It uses Nd:YAG laser to target specific pigmented cells (Melanocytes cells) in trabecular meshwork.
This type of laser has non destructive properties because it lacks the coagulative and thermal damage to trabecular meshwork cells and for this reason it is repeatable procedure.
Sometimes, patients with macular edema require Intravitreal injection of corticosteroid injection in order to improve the visual acuity and to reduce swelling and fluid leakage into the macular area but unfortunately these patients are at high risk to develop steroid induced glaucoma.
A prospective research study showed that SLT can be used before Intravitreal corticosteroid injection in patients with high risk to develop high intraocular pressure.
This study was done on two groups of patients. The first group underwent SLT before Intravitreal corticosteroid injection and the second group had the injection without SLT. After 1 month period of injection, the first group showed a lower intraocular pressure compared to the second group of patients.
Some patients in the second group even required anti glaucoma medications while none from the first group required that.