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Mordechai Goldenfeld

Mordechai Goldenfeld

Sheba Medical Center, Israel

Title: Automated direct selective laser trabeculoplasty: First prospective clinical trial

Biography

Biography: Mordechai Goldenfeld

Abstract

Purpose: Direct Selective Laser Trabeculoplasty (DSLT) is a rapid, non-contact automated procedure performed directly through the limbus without gonioscopy. In this first non- randomized clinical trial to assess its safety and ability to reduce Intraocular Pressure (IOP).

Methods: Fifteen patients (15 eyes: 10 with open-angle glaucoma (OAG), 4 with ocular hypertension, and one with pseudoexfoliation glaucoma), naïve or after medication washout, with an IOP ≥22 mmHg, underwent DSLT by irradiation with 100 or 120 sequential non-contact 532 nm, Q- switched laser shots (0.8−1.4 mJ) automatically applied during 1.5 or 2.3 seconds on the limbus, guided by image analysis and eye tracking. Results were assessed at 1 and 3 hours, 1 day, 1 week, and 1, 3, and 6 months.

Results: The mean ± standard deviation baseline IOP (mmHg) in all eyes was 26.7±2.3. At 1, 3, and 6 months, this value was significantly reduced to 21.7±4.2 (by 18.1%), to 20.8±2.5 (by

21.4%), and to 21.5±4.1 (by 18.8%) respectively. In 6 patients treated with 1.4 mJ/shot, the mean IOP at 6 months decreased from 26.7±3.2 to 19.3±2.0 (27.1%, P=0.03). There was a significant reduction in hypotensive medications (from 1.6±1.0 to 0.4±0.7, P=0.03). No serious adverse events occurred.

Conclusions: Automated DSLT appears to be an effective and safe non-contact, rapid modality for reducing IOP in patients with OAG. Higher energy usage led to better results.

Recent Publications

  1. Mordechai Goldenfeld, Michael Belkin, Masha Dobkin-Bekman, Zachary Sacks, Sharon Blum Meirovitch, Noa Geffen, Ari Leshno, Alon Skaat. Automated Direct Selective Laser Trabeculoplasty: First Prospective Clinical Trial. Translational Vision Science & Technology March 2021,Vol.10,5.
  2. Zachary S. Sacks, Masha Dobkin-Bekman, Noa Geffen, Mordechai Goldenfeld, and Michael Belkin. Non-contact direct selective laser trabeculoplasty: light propagation analysis. Biomedical Optics Express Vol. 11, Issue 6, pp. 2889-2904 (2020).
  3. Noa Geffen, Shay Ofir, Avner Belkin, Fani Segev, Yaniv Barkana, Audrey Kaplan Messas, Ehud I Assia, Michael Belkin. Trasscleral selective laser trabeculoplasty without a gonioscopy lens. Journal of Glaucoma: March 2017 - Volume 26 - Issue 3 - p 201-207.
  4. G.Gazzard et al. Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (Light): A multicentre randomised controlled trial. The Lancet VO 393, ISSUE 10180, P1505-1516, APRIL 13, 2019.
  5. Yujia Zhou & Ahmad A. Aref. A Review of Selective Laser Trabeculoplasty: Recent Findings and Current Perspectives. Ophthalmology and Therapy volume 6, pages 19–32 (2017).