Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
22 Cards in this Set
- Front
- Back
|
What are two types of laser trabeculoplasty?
|
ALT-thermal energy produced by pigment absorption of laser light, shrinkage of collagen shortening of treated TM enlarge spaces btwn. treatment sites
SLT-selectively targets pigmented cells in TM without structural damage to non pigmented cells, no coagulation damage |
|
|
What is the light used with Argon laser?
|
green light
|
|
|
briefly describe the ALT procedure
|
Argonlaser with green light and a goldman three-mirror or one-mirror lens, rich trabeculoplasty lens. 50um spot size, 0.1 second duration, power 500-1000mW at the junction of posterior pigmented and anterior non nonpigmented TM. 180 degrees, 50 applications. desired visual result: depigmentation of the treatment site or small gas bubbles
|
|
|
name possible complications of ALT
|
transient IOP elevation, iritis, peripheral anterior synechiae, hyphema
|
|
|
SLT is used in what types of glaucoma?
|
POAG
|
|
|
IOP reductions have been shown to be maintained for up to how many weeks with SLT
|
26
|
|
|
International studies have shown IOP reductions of what percentage with 37-49wks follow-up?
|
22-28%
|
|
|
what is the advantage of SLT?
|
IOP reducation w/o coagulation damage
|
|
|
Which trabeculoplasty lowers IOP most?
|
trick question! they are equal. SLT 5.86mmHG, ALT 6.04mmHG at one year in open angle glaucoma
|
|
|
briefly describe the procedure used with SLT
|
YAG laser, golaman three-mirri or one-mirrow lens, rich trabeculoplasty lens. 400um spot size, power 0.5-1.0mJ, 360 degrees, 100 spots. potentially repeatable. complications transient IOP.
|
|
|
who qualifies for laser?
|
equivalent to adding a med. compliance si down when medications or increased. traditionally a second or third lien tx.
|
|
|
How do you tx. transient IOP elevation?
|
apraclonidine 1% (Iopidine) sympathomimetic, alpha 2 adrenergic agonist. 1 drop 1 hr. prior to surgery, 1 drop given after procedure is complete
|
|
|
What are secondary side effects of apraclonidine?
|
Lid elevation (muller), 1-3mm elevation. IOP check 1 hr. after procedure
|
|
|
how do you tx. irits associated laser for ALT?
|
Prenisolone 1% QID for 5 days, pretreatment
|
|
|
how do you tx. iritis associated laser for SLT?
|
no tx! SLT effect may depend in part on the action of cytokines and other chemical mediators which maybe inhibited by anti-infl. meds. alternative topical NSAID X 5days
|
|
|
Laser peripheral iridotomy is vs. irdectomy
|
iridectomy is a surgical procedure done in cataract surgery usually. they are already int he eye so they snip out a piece of the iris usually at 10 or 2 o'clock position. you for retroillumination at 10 or 2 and must assess with gonio!
|
|
|
What is a ddx if LPI does not open the angle?
|
plateau iris syndrome, combined mechanism glaucoma, choroidal swelling ie TOPamax, tumor, surgery
Acute vs. Chronic NAG |
|
|
what does ECP stand for?
|
Endo-Cyclophotocoagulation
|
|
|
What is ECP and when is it perform
|
YAG application to destroy the culinary processes; endolaser probe. performed during cataract surgery; ECP can be performed before or after inserting IOL. goal of each laser application is to whiten and shrink the ciliary process. Increased inflammation after cataract surgery.
|
|
|
how do you tx. the increased inflammation after cataract surgery?
|
TID on pred forte. you would just increase dose if this is what they are already on. you can also cycloplege them. or increase your steroid or put other on a steroid
|
|
|
what is cryocyclodestruction?
|
performed with cryo probe 360 post limbus. result in transscleral tissue damage. presently diode laser 810nm wavelength either transscleral or with an endoscopic probe is used to perform CPC. the diode laser is preferred other other wavelengths since the melanin in the ciliary epithelium better absorb this wavelength than other and therefore causes more targeted destruction with less inflammation.
|
|
|
when is cryocyclodestruction indicated?
|
refractory glaucoma or eyes with poor visual acuity or poor visual potential.
|
