Laser affords multiple uses, benefits

A specific diode laser (IQ 810, Iridex Corp.), with its versatility, is one of the latest technologies available for laser trabeculoplasty. Micropulse laser trabeculoplasty (MLT) is a tissue-sparing laser technology that allows fine control of the thermal effects of the laser to minimize thermal spread and collateral damage in the trabecular meshwork.

MLT, similar to selective laser trabeculoplasty (SLT), causes no damage in the eye, compared with argon laser trabeculoplasty (ALT).

Choosing this diode laser was an important part of practice management in his multispeciality group practice, Dr Lish said. He and his colleagues had used a solid-state laser (Coherent) that performed multiple tasks required by a glaucoma specialist and a retina specialist.

When the practice needed a new laser with multifunctional capabilities, his research into various lasers led him to opt for the proprietary 810 nm laser system.

He cited studies published by Fudemberg et al.¹ and Saunders et al.,² who demonstrated that the MLT laser, as well as the SLT laser, did not cause coagulative damage to the trabecular meshwork compared with ALT. This information was important in his choice of the 810 nm laser, which was substantially less expensive than an SLT model and was able to perform all the functions of the practice's ageing laser.

Two other practical advantages, he added, are that the MLT laser is small and portable.

"I found that [while] using the MLT laser, my patients were more comfortable, with less inflammation and no formation of synechiae," said Dr Lish, a clinical instructor at Mount Sinai Medical Center, New York, USA, and a community glaucoma specialist in Brooklyn, New York, USA. "This was in contrast to the argon laser, which is associated with rates of anterior synechiae formation from 30% to 40%."

He added that MLT is equal in efficacy to ALT and SLT.