Abstract
Glaucoma is the most common cause of permanent blindness in the world, caused by a progressive optic neuropathy. Patients with glaucoma are often treated with topical medicines therapy in order to reduce intra-ocular pressure (IOP). On the other hand, laser therapies, with the introduction of Argon Laser Trabeculoplasty (ALT) and successively with Selective Laser Trabeculoplasty (SLT), were reported to be effective in IOP control, with low adverse effect rates. In recent years, the micropulse laser, a subthreshold laser technology, was introduced with the goal of reducing side effects while maintaining the effectiveness of the laser treatments. Several studies focused on Micropulse Diode Laser Trabeculoplasty (MDLT) in open-angle glaucoma, to evaluate its effectiveness and possible side effects. Promising results were reported, but irradiation circumstances have not been standardized yet and its role as a substitute for previous laser techniques has yet to be defined. As a result, the goal of this review was to analyze the physical principles at the basis of MDLT and to frame it in the open-angle glaucoma management setting, highlighting the advantages and shortfalls of this technique.
Highlights
Glaucoma is a progressive optic neuropathy, which has become the biggest cause of permanent blindness across the globe [1]
In primary open-angle glaucoma (POAG), the main goal of treatment is to reduce intraocular pressure (IOP) in order to slow the progression of visual field and retinal nerve fiber layer degeneration
Original research, which assessed Micropulse Diode Laser Trabeculoplasty (MDLT) results on IOP management and possible adverse effects were included, with an emphasis on the comparison between MDLT and selective laser trabeculoplasty (SLT). Since this novel approach may offer a new way to reduce topical drugs burden for glaucoma patients while maintaining a good safety profile, this review aimed to evaluate MDLT results in clinical practice and define whether it can merge with other glaucoma treatments
Summary
Glaucoma is a progressive optic neuropathy, which has become the biggest cause of permanent blindness across the globe [1]. In primary open-angle glaucoma (POAG), the main goal of treatment is to reduce intraocular pressure (IOP) in order to slow the progression of visual field and retinal nerve fiber layer degeneration. In 1995 the selective laser trabeculoplasty (SLT) saw the light [4,5]. Since they have become widely used for the treatment of open-angle glaucoma (OAG) and have been demonstrated to have a similar efficacy for reducing IOP as topical medications while avoiding their side effects [6]. Transient intraocular pressure (IOP) spikes and ocular pain might occur as a result of the inflammatory response and early pigment dispersion, among other things [11]
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