Selective Laser Trabeculoplasty - any experience?

[Peter]

It seems I have somewhat elevated intraocular pressure, and some slight reduction in peripheral vision. Glaucoma, in other words.

I've been offered either drops or Selective Laser Trabeculoplasty. Internet says both are good ways to control further problems, but I was wondering if anyone here has actually had the laser procedure.

What fun it is getting old ...

[LauAnn]

I'm surprised you were offered a laser option prior to trying drops to control/lower your IOP. I've been taking drops for years. My doctor specializes in laser surgery, and he has never offered the laser procedure as an option. I have not researched it, so maybe I am behind the times. On the other hand, I have not experienced any peripheral loss so perhaps the procedure is premature for me. Good luck as you move forward.

[PatSea]

I've had glaucoma in both eyes for over 25 years, no loss of vision. I've had laser surgery and trabeculectomy in right eye, and progression of eyedrops for left eye. I agree with LauAnn that drops are normally used first to control IOP.

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[MichaelB]

Quote:

Originally Posted by Peter It seems I have somewhat elevated intraocular pressure, and some slight reduction in peripheral vision. Glaucoma, in other words. I've been offered either drops or Selective Laser Trabeculoplasty. Internet says both are good ways to control further problems, but I was wondering if anyone here has actually had the laser procedure.

My DM has glaucoma and has been using eye drops forever. When she became forgetful her ocular pressure rose, so her ophthalmologist suggested the SLT. It had no lasting effect and she was soon back on the eye drops, but now with assistance.

Quote:

What fun it is getting old ...

True, but it sure beats that one other option.

[Peter]

Thanks for the responses and observations. The appeal of SLT, of course, is that it avoids the need for daily eye drops. But it seems that, sooner or later, drops will be needed. Still pondering the options ...

[calmloki]

I thought that the wildwood flower was indicated for glaucoma. might as well have fun getting old...

[Live And Learn]

I had iridotomies in both eyes about 7 years ago. Pressures slowly came back up so I had SLTs in both eyes about 2 years ago. Pressures are coming back up but the SLT is repeatable. I was offered drops if SLTs didn't work (in other words, laser as a first option). I went for a second opinion and got the same recommendation.

I'd rather not deal with drops as I am notoriously bad at keeping to a good regime with my meds.

[Paracelsus]

I developed glaucoma in one eye many years before developing it in the other eye. For the first eye they did 4 different pharmacological classes of drops, which I dosed correctly, but didn't work for me. Then they went with the laser trabeculectomy in that eye and it also didn't relieve pressure (my doctor said blue eyes tend not to take to it as well as brown eyes). I finally had a surgical trabeculectomy, which relieved my pressure - the two to three years it took to get to this phase resulted in quite a bit of vision loss in that eye. When I developed glaucoma in the other eye I insisted on going directly to the surgical trabeculectomy to not lose any vision trying other treatments that failed in the other eye. I now have to manually decompress both eyes twice a day, but that option is lots better than dealing with the eye drops, their cost and their side effects.

If your question is about the actual laser trabeculectomy, its a fairly fast procedure taking about ten minutes and doesn't result in any discomfort (you are dosed with a pain relieving drop before the procedure and an eye dilator so wear shades). No down time with the procedure.

[Peter]

Thanks Paracelsus. I've decided to see how I get on with the drops. But after hearing your story, I won't be too inclined to delay if they don't work.

Has your field of vision stabilized now that pressure is under control?

[Paracelsus]

It's stabilized as best as it can be for now, but I count as pretty severely impaired in the eye that was under treatment the longest - wouldn't try to drive if that were my only eye.

[friar1610]

I had SLT after years of taking drops. It had no effect. I eventually had a trabeculectomy on one eye and it seems to have helped. I expect to have the other eye done (trabeculectomy) within the next year or so.

The SLT procedure is benign enough that if it is offered you might want to give it a try. Beats the hell out of a trabeculectomy!

[Peter]

Thanks friar. I asked my doc about doing SLT after trying the drops, and she said "don't leave it too long". I didn't ask why, but I assumed that there was some reason it didn't work as well after some time on the drops. Haven't seen any direct reference to that on my internet searches, so your experience is helpful.

In the meantime, my lower eyelids are darkening, after a couple of weeks on Latanoprost. I gather that is a common side effect.

DW has not objected on aesthetic grounds so far!

[friar1610]

Peter,

I don't recall any discussion of a relationship between how soon one started the SLT and effectiveness. In my case, I had undergone ALT (also without success) a couple of years before SLT was available. It was a very long time between beginning drops and having either of the laser surgeries.

Latanoprost/xalatan was one of the many drops I was on at one time but I developed an allergy to it (something other than lid darkening). Right now I take no pressure-relieving drops in the eye that's had the surgery. In the other I take Azopt 3x daily, Timolol 2x daily and Lumigan every night at bed-time. Good thing I have a good prescription plan!

[Live And Learn]

Quote:

Originally Posted by friar1610 I take Azopt 3x daily, Timolol 2x daily and Lumigan every night at bed-time. Good thing I have a good prescription plan!

WOW - how do you keep track ? I'm so bad with taking prescriptions on time. Your post makes me ever so more thankful that the iridotomies and SLTs had good effect for me.

[kitesurfer2]

so no one even considers smoking pot? It's known in the medical mj community to have positive effects on glaucoma. For $50 you can find out if it works for you vs. expensive medical procedures.

[MichaelB]

Quote:

Originally Posted by kitesurfer2 so no one even considers smoking pot? It's known in the medical mj community to have positive effects on glaucoma. For $50 you can find out if it works for you vs. expensive medical procedures.

During a visit with DM's opthamologist I jokingly suggested that. His response shocked me - it was harsh and angry, he got very much "in my face" to deliver it, part "unproven medical science" and part "dangers of the evil weed". I just smiled and told him he had nothing to worry about - adding if we chose that route we'd ask another Dr for the prescription.

[kitesurfer2]

Quote:

Originally Posted by MichaelB During a visit with DM's opthamologist I jokingly suggested that. His response shocked me - it was harsh and angry, he got very much "in my face" to deliver it, part "unproven medical science" and part "dangers of the evil weed". I just smiled and told him he had nothing to worry about - adding if we chose that route we'd ask another Dr for the prescription.

haha. I had the complete eye exam a few months back. I asked about glaucoma. He said my eye pressure was much lower than normal good eyes. I told him why, he said 'not surprised'.

[friar1610]

Quote:

Originally Posted by Live And Learn WOW - how do you keep track ? I'm so bad with taking prescriptions on time. Your post makes me ever so more thankful that the iridotomies and SLTs had good effect for me.

The times that I take them are synced to mealtimes ( except for the bed-time dose). "Would you like a few drops of Azopt with your tuna sandwich?" Also, My iPod Is set up with all the appropriate alarms. I may miss an occasional dose but I'm sure I take >95% of the doses on time.

[Live And Learn]

Quote:

Originally Posted by friar1610 The times that I take them are synced to mealtimes ( except for the bed-time dose). "Would you like a few drops of Azopt with your tuna sandwich?" Also, My iPod Is set up with all the appropriate alarms. I may miss an occasional dose but I'm sure I take >95% of the doses on time.

Impressive. My mealtimes are irregular but alarms on the phone are a norm for me. Guess I'd just have to add a few others. Do the meds need to be refrigerated ? What if you are out for the day ?

[friar1610]

Quote:

Originally Posted by Live And Learn Impressive. My mealtimes are irregular but alarms on the phone are a norm for me. Guess I'd just have to add a few others. Do the meds need to be refrigerated ? What if you are out for the day ?

No refrigeration required. I remember that my mother had to keep hers refrigerated but I never paid any attention to what she did outside the house. And, yes, glaucoma is hereditary.