"The current data is so
remarkable that some people
don't believe the results," he
says.
4. Subthreshold
micropulse photoco-
agulation
"Subthreshold" is a broad
term that refers to any low-
power laser that does not
yield a visible burn or damage
to the eye's anatomy, says
Peter A. Karth, MD, MBA, a
vitreoretinal physician and
surgeon at Oregon Eye
Consultants in Eugene, Ore.
He says the primary modern subthreshold applications involve the use
of micropulse lasers — which deliver ultra-short bursts of energy — to
treat diabetic macular edema (DME), edema from vein occlusions and
central serous retinopathy, and to reduce intraocular eye pressure in
patients with high intraocular pressure.
Dr. Karth says subthreshold lasers activate heat shock proteins, which
reinvigorate cells in order to help them perform their processes better.
During treatment of DME, the micropulse laser is used to activate cells
that pump fluid out of the eye. During micropulse cyclophotocoagula-
tion in glaucoma patients, the laser targets the ciliary body, causing it to
produce less aqueous humor. He points out that the treatment's effects
are often not dramatic or sufficient enough to stand alone. The treat-
ments may be repeated periodically if they show initial efficacy.
S E P T E M B E R 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 1 2 9
• SKILL SET Surgeons who regularly perform retinal laser proce-
dures won't have a tough time adapting to YAG laser vitreolysis.
Inder
Paul
Singh,
MD
