MUSC to offer new laser treatment for glaucoma patients

Glaucoma patients at MUSC’s Storm Eye Institute will soon have access to a new laser technology that is faster, more comfortable and more precise for treating the most common form of the disease in the United States. 

MUSC is the first in South Carolina and one of only 40 sites in the United States to offer the new laser treatment, said Jella An, M.D., a glaucoma specialist and director of the MUSC Storm Eye Institute’s Glaucoma Fellowship Program.

 

While lasers have been used to treat glaucoma for more than 40 years with a technique called select laser trabeculoplasty (SLT), the newer laser provides advantages to both the patient and the physician, said An, who is also a professor of clinical ophthalmology. 

The new treatment, direct select laser trabeculoplasty (DSLT), does not require the use of a gonio lens, which fits over the patient’s eye during SLT and is bulky and uncomfortable. 

“The gonio lens is not intuitive; it is used manually, and there is a learning curve,” An said. “Instead, DSLT technology uses a scanning device that is automatic and extremely fast. The procedure can be done within five seconds instead of minutes. And because of its precision, it is believed to lead to better results for the patient.” 

Unlike SLT, DSLT can be used on patients with corneal disease as well as on patients who are difficult to position for the procedure. 

“These are two important distinctions that will allow more patients to have access to laser treatment,” An said. 

According to the National Eye Institute, 2.7 million people in the United States have some form of glaucoma, and that number is expected to increase to 4.3 million by 2030. 

Glaucoma is a term for multiple diseases that damage the eye’s optic nerve and can cause peripheral vision loss.

“It occurs when excess fluid accumulates in the front of the eye and is unable to drain through the trabecular meshwork, which is the eye’s natural drainage system,” An explained. “As a result, eye pressure increases or interocular pressure builds up.” 

According to An, eye pressure is just one risk factor for developing the disease – but one of the most important because it is the only treatable risk factor that is also measurable. “This is why we measure interocular pressure at every glaucoma visit and do visual field and optic nerve scans to assess the stability or progression of the disease.” 

Other factors include age, family history of the disease and ethnicity. African Americans, Hispanics and Asians are at higher risk.

The most common form of glaucoma in the United States is primary open angle glaucoma (POAG), which is treated with eye drops, surgery or laser.

Laser treatment for POAG rejuvenates the trabecular meshwork by using a cold laser to activate cells that work to bring down eye pressure. In DSLT, a scanner is used to apply the energy automatically and simultaneously. The laser energy can be applied directly onto the trabecular meshwork without even touching the eye.

An said another benefit of the new laser is eye pressure returns to normal in most patients within six to eight weeks, and there is no recovery time and no side effects.

“About 80% of patients will respond to laser treatment,” An said.

Studies show that laser treatment can be offered earlier in the disease process and used as a repeat therapy if eye pressure increases.

Based on the latest research, MUSC is offering laser treatment earlier and more often for patients diagnosed with glaucoma. 

An, who joined the Storm Eye Institute from Johns Hopkins University, said she was drawn to MUSC by its reputation for excellence and innovation. 

“I was immediately impressed by the innovative minds at Storm Eye and the commitment of the physicians to provide the best care for our patients. Because of the large volume of patients we see, everyone is outstanding, including our trainees, residents and fellows. This breadth of knowledge makes for a multidisciplinary care team that supports one another and is dedicated to delivering state-of-the-art treatments.”