Tuesday, November 26, 2013

Excerpt from: In-Clinic IOP: How Much Does It Tell Us? Review of Ophthalmology

Review of Ophthalmology
11/7/2013
Arthur J. Sit, SM, MD, Rochester, Minn.

Read the full article here

Excerpt from: In-Clinic IOP: How Much Does It Tell Us?
Determining the clinical value of mean vs. peak IOP-and the possible importance of IOP fluctuation-remains a challenge.
 

(excerpted from the article)
Consider performing laser trabeculoplasty.  One of the less-often discussed results of using a procedure such as selective laser trabeculoplasty is that IOP fluctuation is reduced. The likely explanation is that it enhances outflow facility, leading to a more consistent IOP over the course of the day. In addition, it's a very low risk procedure. Given that it smooths out IOP fluctuation, it makes sense to try it in patients whose IOP seems well-controlled but who continue to get worse.

In the United States, clinicians still don't perform SLT very frequently, often because of the perception that it doesn't reduce IOP as much as other alternatives. I believe that perception is partly the result of the frequent use of SLT as a last resort. Once a patient is already on maximum medical therapy, even adding another drop will have minimal effect, so it shouldn't be a surprise that SLT doesn't cause a major change under these conditions.

In my experience, you'll see a larger effect if you perform SLT earlier in the course of treatment, before the patient is on multiple medications. I think it's a reasonable option to offer earlier in the treatment spectrum, not only to reduce IOP, but also to achieve a better quality of IOP control -i.e., reduced fluctuation-than you might get with something like a beta-blocker.

Read the full article here.
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• Consider performing laser trabeculoplasty. One of the less-often discussed results of using a procedure such as selective laser trabeculoplasty is that IOP fluctuation is reduced.6,7 The likely explanation is that it enhances outflow facility, leading to a more consistent IOP over the course of the day. In addition, it’s a very low-risk procedure. Given that it smoothes out IOP fluctuation, it makes sense to try it in patients whose IOP seems well-controlled but who continue to get worse.

In the United States, clinicians still don’t perform SLT very frequently, often because of the perception that it doesn’t reduce IOP as much as other alternatives.I believe that perception is partly the result of the frequent use of SLT as a last resort. Once a patient is already on maximum medical therapy, even adding another drop will have minimal effect, so it shouldn’t be a surprise that SLT doesn’t cause a major change under these conditions.

In my experience, you’ll see a larger effect if you perform SLT earlier in the course of treatment, before the patient is on multiple medications. I think it’s a reasonable option to offer earlier in the treatment spectrum, not only to reduce IOP, but also to achieve a better quality of IOP control—i.e., reduced fluctuation—than you might get with something like a beta-blocker. - See more at: http://www.revophth.com/content/d/glaucoma_management/i/2625/c/44885/#sthash.9JfS9SjG.dpuf

• Consider performing laser trabeculoplasty. One of the less-often discussed results of using a procedure such as selective laser trabeculoplasty is that IOP fluctuation is reduced.6,7 The likely explanation is that it enhances outflow facility, leading to a more consistent IOP over the course of the day. In addition, it’s a very low-risk procedure. Given that it smoothes out IOP fluctuation, it makes sense to try it in patients whose IOP seems well-controlled but who continue to get worse.

In the United States, clinicians still don’t perform SLT very frequently, often because of the perception that it doesn’t reduce IOP as much as other alternatives.I believe that perception is partly the result of the frequent use of SLT as a last resort. Once a patient is already on maximum medical therapy, even adding another drop will have minimal effect, so it shouldn’t be a surprise that SLT doesn’t cause a major change under these conditions.

In my experience, you’ll see a larger effect if you perform SLT earlier in the course of treatment, before the patient is on multiple medications. I think it’s a reasonable option to offer earlier in the treatment spectrum, not only to reduce IOP, but also to achieve a better quality of IOP control—i.e., reduced fluctuation—than you might get with something like a beta-blocker. - See more at: http://www.revophth.com/content/d/glaucoma_management/i/2625/c/44885/#sthash.9JfS9SjG.dpuf

Wednesday, October 2, 2013

SLT Laser Best Response as First Treatment Modality

Review of Ophthalmology Article
6/13/2011
by Walter Berthke, Managing Editor     read the full article here

SLT on the Front Lines of Treatment

Some surgeons say SLT's safety and efficacy make it a good candidate for first-line therapy.

( We do not have permission to reproduce portions of the article, so this is a short description of the results that we read.   read the full article here)

Success factors for SLT were studied, considering medications, previous treatments, and pigmentation, and the only consistent factor predictive of SLT response was "you get your biggest response when the pressure's high and the patient is treatment naive."

Cindy Hutnik, MD, PhD, associate professor of ophthalmology and pathology at the University of Western Ontario


Here, glaucoma experts explain why they think it’s reasonable to offer SLT alongside prostaglandins as an option for initial therapy. - See more at: http://www.revophth.com/content/i/1533/c/28664/#sthash.JblcRvqB.dpuf
Here, glaucoma experts explain why they think it’s reasonable to offer SLT alongside prostaglandins as an option for initial therapy. - See more at: http://www.revophth.com/content/i/1533/c/28664/#sthash.JblcRvqB.dpuf






SLT’s Acceptance
The prostaglandin analogs are very effective,
The prostaglandin analogs are very effective,
The prostaglandin analogs are very effective,
The prostaglandin analogs are very effective,

Walter Bethke, Managing Editor
Walter Bethke, Managing Editor
Walter Bethke, Managing Editorv
Walter Bethke, Managing Editor
Walter Bethke, Managing Editor


The prostaglandin analogs are very e
The prostaglandin analogs are very e

SLT on the Front Lines of Treatment

Some surgeons say SLT's safety and efficacy make it a good candidate for first-line therapy.
Walter Bethke, Managing Editor
6/13/2011
- See more at: http://www.revophth.com/content/i/1533/c/28664/#sthash.JblcRvqB.dpuf



SLT on the Front Lines of Treatment

Some surgeons say SLT's safety and efficacy make it a good candidate for first-line therapy.
Walter Bethke, Managing Editor
6/13/2011
- See more at: http://www.revophth.com/content/i/1533/c/28664/#sthash.JblcRvqB.dpuf


SLT on the Front Lines of Treatment

Some surgeons say SLT's safety and efficacy make it a good candidate for first-line therapy.
Walter Bethke, Managing Editor
6/13/2011
- See more at: http://www.revophth.com/content/i/1533/c/28664/#sthash.JblcRvqB.dpuf

Tuesday, September 10, 2013

Pseudotumor Prevalent? Pseudotumor cerebri

I was speaking to a neuro-ophthalmologist as my SLT laser was in use at Fletcher Allen Medical Center in Burlington, VT the other day, and he said he is seeing 3 or 4 cases of Pseudotumor A DAY!!

What is pseudotumor? 

From Mayoclinic.com.

Pseudotumor cerebri occurs when the pressure inside your skull (intracranial pressure) increases for no obvious reason. Symptoms mimic those of a brain tumor, but no tumor is present. Pseudotumor cerebri can occur in children and adults, but it's most common in obese women of childbearing age.

Symptoms of Pseudotumor

By Mayo Clinic staff
Pseudotumor cerebri signs and symptoms may include:
  • Moderate to severe headaches that may originate behind your eyes, wake you from sleep and worsen with eye movement
  • Ringing in the ears that pulses in time with your heartbeat
  • Nausea, vomiting or dizziness
  • Blurred or dimmed vision
  • Brief episodes of blindness, lasting only a few seconds and affecting one or both eyes (visual obscurations)
  • Difficulty seeing to the side
  • Double vision (diplopia)
  • Seeing light flashes (photopsia)
  • Neck, shoulder or back pain
Mayo Clinic this page online here.
More on pseudotumor online at
North American Neuro-Ophthalmology 
Society

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Doctors, rent an SLT Laser for the day from us.
Contact

Lauren Teton

Marketing Manager, Option3 LLC

Westchester County, NY

914 764-0115

Tuesday, August 27, 2013

SLT Laser FAQs for Patients

SLT or Selective Laser Trabeculoplasty is a quick, simple, bloodless, laser procedure with a high degree of success for lowering high intraocular pressure in the eye, which can be a sign or symptom of glaucoma. The procedure is an outpatient surgery, and patients can return to regular activities the same day.




Find the answer to these Frequently Asked Questions about SLT here.

Find the answer to these Frequently Asked Questions about SLT here at http://www.glaucomaslt.com/faqs

Find a physician who offers SLT here.

Doctors, rent an SLT Laser for the day.
Contact
Lauren Teton

Marketing Manager, Option3 LLC

Westchester County, NY

914 764-0115

SLT Technology is Changing How Surgeons Lower IOP


Paul Krawitz, MD of Huntington Eye Care Associates on Long Island was a twice-a-month customer of our Option3 LLC Mobile SLT Rental Service, and saw better results using SLT than ALT.  Here are excerpts from a recent article in
Ophthalmology Management.

Lumenis Laser Grows Surgical Repertoire
By Bill Kekevian, Senior Associate Editor
June 2013 Ophthalmology Management

Read the article here.

From the article

"He estimates that 90% of his patients are getting a meaningful lowering of IOP after the SLT procedure."
"The Lumenis has far exceeded our expectations," Dr. Krawitz says. Besides patients embracing the procedure, IOP control has also improved beyond what he anticipated.

Read the article here.


See Dr. Paul Krawitz in video here

"Dr. Paul Krawitz discusses the benefits and results of SLT rather than eyedrops for glaucoma" (video)

4:34 "In new glaucoma patients, when given both options, drops, vs. laser, and presented with the evidence, nearly 100% of my patients are opting for SLT."

See Dr. Paul Krawitz in video here

Use SLT in your office with a daily rental. Contact us here