It is the first study of its kind to track the effectiveness of SLT laser treatment over 10 years. The procedure, known as Selective Laser Trabeculoplasty, was approved by the FDA in 2001. The findings are significant because for many patients it eliminates the need for medications to control glaucoma and has little to no side effects, according to Dr. Jindra.
"The laser treatment takes only a few minutes in the doctor's office and causes little to no discomfort, nor side effects to speak of. It is covered by Medicare and most insurance plans," he explains. "Although prescription eye drops are also effective in controlling glaucoma, patients must remember to use them every day for the rest of their lives. The medications may cause side effects and can be costly. Patient compliance is always a concern with use of medications, but this is not an issue with SLT laser treatment, which can be repeated, if necessary." Studies show that 40 percent of glaucoma patients do not use their eye drops as prescribed.
A report of the study, recently featured in Ophthalmology Times, found that the SLT laser proved to be successful long-term in significantly lowering pressure inside the eye, the goal in treating glaucoma. In an analysis of almost 2,000 eyes treated with SLT as the primary therapy, the cumulative probability of success at 10 years was 90 percent.
Reviewing patient charts, data were collected from 1,983 eyes out of over 4,000 eyes treated with SLT over a period of more than 10 years. The average follow-up was 917 days. The study found that the cumulative probability of success was 97 percent one year after treatment; 92 within five years of treatment; and 90 percent after 10 years.
Dr. Jindra, who sees patients in his Floral Park, Long Island, office, was one of the first physicians in the United States to acquire the SLT laser after it was approved by the FDA to treat glaucoma in 2001.
The SLT, sometimes called a "cold laser," has the ability to zero in on specific pigment-containing cells to lower pressure in the eye caused by a buildup of fluid. It is a gentler treatment compared to the traditional "hot" argon laser used in the past. "SLT has less energy than the average laser used to scan groceries at the supermarket checkout," Dr. Jindra said. "So it does not cause thermal damage to surrounding tissue."
In the most common form of glaucoma, the drainage system in the eye fails to function properly. "If you compare the eye to a sink, it's like having a clogged drain," he explains. "Fluid cannot leave the eye as quickly as it is produced, causing it to back up, and this leads to increased pressure in the eye. If the pressure is not controlled, it can damage the optic nerve and cause permanent and irreparable vision loss."
Glaucoma is often called the "sneak thief of sight" because there are no early symptoms, and its incidence is on the rise. In the year 2000, 2.2 million Americans had glaucoma, according to the National Eye Institute. By 2010, that number jumped to more than 2.7 million, and half of those with the disease do not know they have it. The National Eye Institute projects this number will reach 4.2 million by 2030.
"In this day and age, it's a tragedy for anyone to experience vision loss or go blind because of glaucoma," Dr. Jindra says. "Regular eye exams, timely diagnosis, and early and effective treatment are the best ways to preserve one's precious sight, especially if someone has risk factors for the disease."
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Glaucoma: A Leading Cause of Blindness
Glaucoma has no early warning signs, and left untreated, it can lead to permanent vision loss or blindness. Regular eye exams, especially for those at increased risk, are important. People can go for years without symptoms, and by the time they begin to not notice changes in their vision, irreversible damage has occurred.
Left untreated, the disease initially leads to a loss of peripheral vision. People may have the impression they are looking through a tunnel. Over time, their remaining straight-ahead vision may deteriorate until they lose their sight altogether. Although there is no cure, researchers have found that promptly diagnosing and treating people who have early stage glaucoma can delay progression of the disease.
The American Academy of Ophthalmology has the following recommendations with respect to glaucoma screenings:
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