ABSTRACT
PURPOSE: To compare two regimens of SLT, ie, SLT with 25 laser spots on 90 degrees of trabecular meshwork and SLT with 50 laser spots on 180 degrees of trabecular meshwork in patients with open-angle glaucoma. PATIENTS AND METHODS: In a prospective clinical study, the authors compared pressure-lowering effect of SLT in 2 groups of patients; 1 group (32 patients) received SLT with 25 laser spots on 90 degrees of trabecular meshwork, the other group (32 patients) SLT with 50 laser spots on 180 degrees of trabecular meshwork. RESULT: There was no difference in the pressure reduction between these two treatment regimens. Moreover, the pressure reduction was not influenced by previous ALT treatments. The pigmentation in the trabecular meshwork is related to a delayed effect on the pressure lowering after SLT. CONCLUSION: SLT with 25 laser spots on 90 degrees of trabecular meshwork has a similar pressure-lowering effect to SLT with 50 laser spots on 180 degrees of trabecular meshwork. The new treatment regimen with less laser spots could increase the repeatability of SLT and reduce potential tissue damage in the trabecular meshwork.
Subject(s)
Glaucoma/surgery , Laser Therapy/methods , Ocular Hypertension/surgery , Trabeculectomy/methods , Aged , Aged, 80 and over , Female , Glaucoma/physiopathology , Humans , Intraocular Pressure , Laser Therapy/standards , Male , Middle Aged , Ocular Hypertension/physiopathology , Prospective Studies , Reoperation , Trabeculectomy/standardsABSTRACT
Since 2000, routine tele-ophthalmology services have been provided by St Erik's Eye Hospital to three large urban primary care centres in Stockholm. Diagnostic support from the specialist eye hospital to primary care centres uses video slit-lamps and realtime videoconferencing. After the initial introduction period at the primary care centres, the number of teleconsultations stabilized at a very low level. Despite this, the general practitioners learned to handle more diagnostic conditions by themselves and to identify what diagnostic situations should be referred to a specialist without having to consult the specialist beforehand via telemedicine. The availability of instant eye expertise via telemedicine therefore proved to be an excellent on-the-job training tool to develop and maintain the diagnostic competence of general practitioners. Patient satisfaction was high.
