3.6 years ago

anonymous FitEyes member ♦ 1.1k

@member_31

How many different types of laser surgeries are there now for lowering IOP? What is the efficacy of each for lowering intraocular pressure?

3.6 years ago

david 4.3k

@david_fe

The main laser surgery options for lowering intraocular pressure are currently:

• ALT: Argon Laser Trabeculoplasty
• SLT: Selective Laser Trabeculoplasty
• MLT: Micropulse Laser Trabeculoplasty
• MP-TSCPC: Micropulse transscleral cyclophotocoagulation

Of these, ALT is no longer widely used as SLT effectively replaced it. MLT is a further improvement on SLT, although that improvement is minor and doesn't result in improved efficacy. Both SLT and MLT typically provide pressure reduction in the range of only 10-20%. This is a relatively small reduction in IOP, but it may be sufficient for some patients.

In addition, you may encounter:

• Pattern Scanning Laser Trabeculoplasty
• Excimer Laser Trabeculoplasty
• Titanium Sapphire Laser Trabeculoplasty

MP-TSCPC, a cyclophotocoagulation technique, has the greatest potential to lower IOP and is growing in popularity, although it is not perfect. One main drawback is that its efficacy can be unpredictable. See this related question about Micropulse transscleral cyclophotocoagulation. When it works, the IOP reduction can be 30% or more. In the answer on MP-TSCPC, Dr. Richardson gives an example of a patient who saw an IOP reduction from 40 to 10 mmHg.

In addition to MP-TSCPC, you may encounter older cyclophotocoagulation techniques, such as:

• TSCPC: Transscleral cyclophotocoagulation
• ECP: endocyclophotocoagulation
• HIFU: High-intensity Ultrasound

This page is recommended as a good reference by a FitEyes member: Glaucoma Pipeline: Surgical