Chapter 37: Principles of Laser Surgery for Glaucoma

Yaldo Luke, Ting Albert, Pasha Saif et al.

This meta-analysis found 360-degree laser retinopexy during RRD repair improves single-surgery success over focal laser, without increased complications, but no visual acuity benefit.

Realini Tony, Balasubramani G K, Kenkre Tanya et al.

The COAST trial compares standard versus low-energy SLT for new glaucoma/OHT. The abstract details the study design and baseline patient characteristics, showing a representative sample, which will clarify optimal SLT use for long-term glaucoma management.

Sng Jie James, Park Ki Ho, Kim Young Kook et al.

AS-OCT revealed persistent structural differences in primary angle closure disease eyes even after LPI, suggesting its utility for assessing risk and severity post-treatment.

Chansangpetch Sunee, Puttiteerachot Thitiwat, Ratanawongphibul Kitiya et al.

This study found 16% of glaucoma patients experienced transient IOP spikes after micropulse transscleral laser therapy; alpha-2 adrenergic agonists significantly reduced this risk, suggesting a protective role.

Zhang Wan-Ping, Lv Hai-Jun, Pan An-Peng et al.

Femtosecond lasers revolutionize ophthalmology, offering precise tissue manipulation across diverse applications from refractive surgery to glaucoma, with emerging frontiers, despite cost and safety challenges.

Taylor Kirby, Mosenia Arman, Bowden Eileen C

Recent trials (LiGHT, ZAP, EAGLE, TAGS, PTVT) show laser and surgical advancements are reshaping glaucoma management, offering tailored first-line and advanced treatment options for better patient outcomes.

Wang Xinyu, Wang Yunxiao, Xue Shasha et al.

LPI shifts the lens posteriorly and improves its stability in PACD, especially in PACG, which may impact IOL power calculations.

Servillo Andrea, Tun Tin A, Yoo Chungkwon et al.

This study found laser iridotomy sustained angle widening in two-thirds of patients. Persistent angle closure, seen in 33%, was predicted by a thicker iris and younger age, guiding personalized treatment.

Lin Jingjing, Mao Jianbo, He Meihui et al.

AS-OCTA-guided LPI for angle-closure suspects significantly reduced bleeding and inflammation compared to slit lamp guidance, improving safety and clinical outcomes by selecting less vascularized iris sites.

Montesano Giovanni, Crabb David P, Garway-Heath David F et al.

First-line SLT better preserved visual fields over six years than drops in glaucoma/OHT patients. SLT should be preferred as initial treatment.

Keidel Leonie Franziska, Eckardt Franziska, Nobl Matthias et al.

This study found continuous wave transscleral cyclophotocoagulation causes more early inflammation and macular edema than micropulse, but both methods offer similar pain and quality of life outcomes.

Koçer Ali Mert

This study found LPI characteristics (size, distance from pupil) influence anterior segment changes. A smaller LPI relative to pupil size or LPI placed too peripherally may reduce treatment efficacy, guiding optimal LPI placement.

Zajner Chris, Pandya Bhadra, Balas Michael et al.

This meta-analysis of TSCPC for refractory glaucoma found no significant visual acuity decrease overall, but higher energy correlated with worse vision, highlighting treatment nuance.

Liu Jocelyn, Kim Iris M, Chen Evan M et al.

US glaucoma specialists increasingly prefer SLT over topical medications for treatment-naive open-angle glaucoma, indicating a shift towards SLT as a primary therapy.

Vu Daniel M, Gilbert Joshua B, Goldberg Eric A et al.

A study of 1.1 million patients found preoperative gonioscopy was coded in only 63.2% before glaucoma procedures, lower than expected. This suggests underutilization or under-coding, particularly before MIGS, impacting surgical planning.

Tan Jeremy C K, Clement Colin I, White Andrew et al.

Prior SLT was associated with increased failure rates after phaco-iStent surgery, suggesting SLT may reduce subsequent iStent efficacy, impacting treatment sequencing decisions.

Wan Yue, Guo Xinzheng, Wang Ningli

The trabecular meshwork's dysfunction is central to glaucoma's elevated eye pressure. New therapies, from drugs to gene and cell-based approaches, are targeting the TM to restore function and improve glaucoma treatment.

Yang Chi-Chun, Ko Yu-Chieh, Hwang De-Kuang et al.

IPL for MGD improved dry eye in both groups, but glaucoma patients on topical meds showed less sustained improvement in symptoms and telangiectasia, suggesting medication impact on long-term efficacy.

Chan Poemen P, Zhang Xiulan, Aung Tin et al.

Experts established consensus on acute angle closure attack (APACA) management, recommending iridoplasty, paracentesis, pupilloplasty for rapid IOP reduction, and earlier phacoemulsification to prevent vision loss.