Excimer Laser Trabeculostomy

Michael S. Berlin, MD, director of the Glaucoma Institute of Beverly Hills, discusses excimer laser trabeculostomy (ELT) for treatment of outflow obstructions in open-angle glaucoma patients. During an ELT procedure, a 380 nm xenon chloride laser with a fiber optic delivery system creates 5 to 6 180 micron openings in the trabecular meshwork, to reestablish normal outflow without disturbing the outer wall of Schlemm’s canal. The technique minimizes tissue destruction and avoids creation of a secondary aqueous, preventing the inflammation and scarring that often leads to channel re-closure after more invasive trabeculopuncture surgeries. Use of the excimer laser system for microinvasive glaucoma surgery is currently under consideration by the FDA.