Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
Issue link: http://outpatientsurgery.uberflip.com/i/873929
have an effective pre-op diagnostic tool to know where the resistance to the outflow of aqueous humor is located within the eye. He explains that the pathophysiology of glaucoma is different in each patient, meaning the natural draining of aqueous humor from the tra- becular meshwork through Schlemm's canal and into a distal channel can be impeded at any of those locations. Plus, he points out, MIG devices are designed to work in different parts of the fluid outflow system. His research has shown that patients who had first undergone SLT responded better to having a stent implanted to divert fluid around blockages in the trabecular meshwork. "SLT works primarily at the level of the trabecular meshwork," says Dr. Singh. "If it works, that's where the resistance to outflow is located. If it doesn't work, the resistance is distal to the meshwork." SLT laser treatment is therefore developing into a way for surgeons to know pre-operatively where the resistance to aqueous humor outflow is located, says Dr. Singh. "There's new thinking of using SLT not only as a therapeutic treatment to bring down eye pressure," he says, "but also as potential first-line diagnostic tool, so surgeons can better decide which MIG device to implant or which procedure to perform." 3. Retinal rejuvenation This proprietary nanosecond laser treatment of early-stage age-related macular degeneration and diabetic macular edema (DME) has shown promise in Europe, but is not yet available stateside. The laser targets and stimulates cells in the retinal pigment epithelium (RPE) and Bruch's membrane to release enzymes that have been shown to repopulate the cells in those areas to improve the permeability of Bruch's membrane and reduce retinal pathologies, including age-relat- ed macular degeneration and macular edema, according to Dr. Singh. 1 2 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • S E P T E M B E R 2 0 1 7