{"id":71,"date":"2013-07-15T10:39:55","date_gmt":"2013-07-15T09:39:55","guid":{"rendered":"http:\/\/www.vision-laser.fr\/?page_id=71"},"modified":"2025-11-19T17:36:54","modified_gmt":"2025-11-19T16:36:54","slug":"laser-slt","status":"publish","type":"page","link":"http:\/\/www.vision-laser.fr\/en\/le-glaucome\/laser-slt\/","title":{"rendered":"Glaucoma operation: Laser treatment"},"content":{"rendered":"

Open-angle glaucoma can be operated on with an argon laser or more recently with a SLT (Selective) laser<\/strong>. It consists of making impacts in the angle between the iris and the cornea, more precisely on the trabecular meshwork. It has the effect of widening the meshwork of the trabecular meshwork, allowing it to be more permeable to aqueous humor and therefore reducing eye pressure<\/strong><\/a>.<\/p>\n\n\n\n

The operation is performed without hospitalization, it is technically simple and can be done at the ophthalmologist's office. Anesthetic eye drops are instilled on the eye and a contact lens is placed on the eye in order to practice the laser.<\/p>\n\n\n\n

The after-effects of Glaucoma laser treatment surgery<\/strong> are simple. At most, there is irritation of the eye that lasts a few hours. An anti-inflammatory treatment is then prescribed for about a week. This treatment is effective because it reduces eye pressure by almost 30%, which allows you to stop taking eye drops or reduce the number prescribed.<\/p>\n\n\n\n

Mais son efficacit\u00e9 est transitoire. La tension oculaire peut remonter apr\u00e8s quelques ann\u00e9es dans pr\u00e8s de 40 % des cas.
Le principal avantage du laser S\u00e9lectif par rapport \u00e0 l\u2019Argon est la possibilit\u00e9 du fait de son absence d\u2019effets thermiques et son innocuit\u00e9 de retraiter le patient au laser apr\u00e8s quelques ann\u00e9es.
Un traitement m\u00e9dical peut \u00eatre \u00e9galement r\u00e9instaur\u00e9 apr\u00e8s quelques ann\u00e9es.<\/p>\n\n\n\n

Angle-closure glaucoma can be treated with laser<\/strong>. It consists of opening the iris to prevent it from blocking the trabecular meshwork when it relaxes. Angle-closure glaucoma surgery is performed without hospitalization with the same after-effects and procedures as in laser surgery for open-angle glaucoma but with another laser: YAG laser<\/strong>.<\/p>\n\n\n\n

 <\/p>\n\n\n\n

The SLT Laser<\/h2>\n\n\n\n

Mis au point en 1995 et approuv\u00e9 par la FDA (Foods and drugs administration USA) en 2001,  le SLT est un nouveau type de laser qui permet de traiter le glaucome en r\u00e9g\u00e9n\u00e9rant le trab\u00e9culum de l’angle irido-corn\u00e9en.<\/p>\n\n\n\n

More than 3,000 centers are equipped with it worldwide, including 1,700 in the USA and around a hundred in France, including the Paris Ouest Vision Laser Center.<\/p>\n\n\n\n

Le laser SLT qui a fait la preuve de son efficacit\u00e9 et de son innocuit\u00e9 est un nouveau traitement de r\u00e9f\u00e9rence dans le glaucome \u00e0 angle ouvert.<\/p>\n\n\n\n

A hundred international scientific publications have confirmed its effectiveness and its place in this glaucoma operation.<\/p>\n\n\n\n

The data for our study come from these publications and from the summary presented by Professor Philippe Denis of the Hospices Civils de Lyon.<\/p>\n\n\n\n

 <\/p>\n\n\n\n

How it works<\/h2>\n\n\n\n

The trabeculum is one of the structures of the iridocorneal angle allowing the filtration of aqueous humor.<\/p>\n\n\n\n

The SLT laser allows regeneration of the trabecular meshwork without creating tissue burns as is the case with the Argon laser.<\/p>\n\n\n\n

Il procure une baisse tensionnelle identique \u00e0 celle obtenue avec trab\u00e9culectomie Argon sans en avoir les effets thermiques ind\u00e9sirables, ni la fibrose.
La baisse tensionnelle est de pr\u00e8s de 30% de la pression initiale ce qui, en terme d’efficacit\u00e9, le place favorablement par rapport aux collyres utilis\u00e9s en monoth\u00e9rapie.<\/p>\n\n\n\n

C\u2019est un traitement \u00e0 faible \u00e9nergie (pr\u00e8s de 100 fois moindre qu\u2019avec laser Argon) donc non invasif et s\u00e9curisant ce qui autorise les retraitements (ce qui le diff\u00e9rencie encore des lasers thermiques \u00e0 Argon).<\/p>\n\n\n\n

 <\/p>\n\n\n\n

Results: decreased eye pressure<\/h2>\n\n\n\n

Le Laser SLT permet une baisse de tension oculaire de 20 \u00e0 30% de la pression initiale,  ce qui le place favorablement par rapport \u00e0 une monoth\u00e9rapie m\u00e9dicale.<\/p>\n\n\n\n

The higher the initial pressure, the more effective the laser will be.<\/p>\n\n\n\n

The effect will be judged after 1 month.<\/p>\n\n\n\n

It remains effective in the long term since according to studies the pressure drop would still be 20% after 5 years.<\/p>\n\n\n\n

A therapeutic escape is nevertheless often observed but it will then be wise to do it again because it retains the same effectiveness in the event of reprocessing.<\/p>\n\n\n\n

SLT retreatments are harmless because it is a non-invasive method.<\/p>\n\n\n\n

 <\/p>\n\n\n\n

Possible side effects<\/h2>\n\n\n\n

Sometimes, pain or rather transient ocular discomfort may be observed after treatment, sometimes moderate post-operative ocular inflammation prevented if necessary by anti-inflammatory eye drops.<\/p>\n\n\n\n

Immediate and short-lived postoperative pressure spike is rare.<\/p>\n\n\n\n

No long term side effects.<\/p>\n\n\n\n

 <\/p>\n\n\n\n

Contraindications<\/h2>\n\n\n\n

Congenital glaucoma,<\/p>\n\n\n\n

juvenile,<\/p>\n\n\n\n

post uveitic,<\/p>\n\n\n\n

neovascular,<\/p>\n\n\n\n

and closed or very narrow angle.<\/p>\n\n\n\n

 <\/p>\n\n\n\n

Conducting glaucoma surgery during an SLT laser session<\/h2>\n\n\n\n

The session takes place in a clinic or medical office.<\/p>\n\n\n\n

The patient is awake, a few drops of anesthetic eye drops are instilled into the eye just before the session.<\/p>\n\n\n\n

Depending on the case, preparatory eye drops are prescribed one hour before and after the session.<\/p>\n\n\n\n

The patient sits in front of the laser with the eye held open by a contact lens.<\/p>\n\n\n\n

La s\u00e9ance dure environ 1 minute et est indolore, le patient pouvant travailler et reprendre ses activit\u00e9s 1\/2 heure apr\u00e8s la s\u00e9ance.<\/p>\n\n\n\n

It is usual to offer a 2nd session 2 to 4 weeks after the first.<\/p>\n\n\n\n

The final effect on blood pressure is seen after one month.<\/p>\n\n\n\n

It will therefore be necessary to continue the previous medical treatment and reduce it after a month depending on the reduction in blood pressure achieved.<\/p>\n\n\n\n

Argon Laser Trabeculectomy or SLT is reimbursed by Social Security (and Mutual Insurance Companies) as part of this glaucoma operation.<\/p>\n\n\n\n

 <\/p>\n\n\n\n

Place of laser in the treatment of glaucoma<\/h2>\n\n\n\n

Il est habituel de commencer par un traitement m\u00e9dical, sauf dans certaines indications o\u00f9 le Laser peut \u00eatre propos\u00e9 d’embl\u00e9e.<\/p>\n\n\n\n

Le Laser est indiqu\u00e9 en cas de mauvaise observance ou de mauvaise tol\u00e9rance au traitement par collyres.<\/p>\n\n\n\n

It is also indicated to reduce the number of eye drops prescribed.<\/p>\n\n\n\n

Il permet \u00e9galement d’\u00e9viter ou de retarder le recours \u00e0 la chirurgie ou en cas de r\u00e9sultat d\u00e9cevant de la chirurgie.<\/p>\n\n\n\n

Please note that the use of the SLT Laser does not reduce the chances of success of the surgery or the effectiveness of any eye drop treatment that may be prescribed subsequently.<\/p>\n\n\n\n

Conclusions<\/h2>\n\n\n\n

L’efficacit\u00e9 du Laser SLT afin d’abaisser la tension oculaire \u00e0 long terme a \u00e9t\u00e9 prouv\u00e9e au travers d’une centaine d’\u00e9tudes internationales.<\/p>\n\n\n\n

Elle est \u00e9quivalente \u00e0 l\u2019Argon dans le traitement des glaucomes \u00e0 angle ouvert.<\/p>\n\n\n\n

It is equivalent or even more effective than antiglaucomatous eye drops used as monotherapy.<\/p>\n\n\n\n

Studies confirm the absence of thermal effects and validate this non-invasive method with an excellent safety profile.<\/p>\n\n\n\n

Retreatments are possible without risk of altering the chances of future surgery.<\/p>\n\n\n\n

The SLT Laser is therefore the new reference solution for glaucoma surgery.<\/p>\n\n\n\n

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