Letter to the Editor of JOG Regarding “Damage to Another Single Use, One Mirror Trabeculoplasty Lens During Routine Selective Laser Trabeculoplasy”

Single-Use Lens Compromise During Selective Laser Trabeculoplasty

“…Damage sustained by these lenses during SLT can obscure the physician's view and complicate treatment, requiring frequent repositioning and lens rotation to complete the procedure. 6,7 Furthermore, the authors have observed that some lenses used within this institution sustain more damage on their reflective coating than others. We hypothesize that there may be numerous potential reasons for this variability, including clinician preference (some clinicians may have a low tolerance for any obstructions in the reflected image of patients' trabecular meshwork, causing them to reposition the lens more frequently), clinician age (nonpresbyopic clinicians may be accommodating during the procedure, resulting in the laser being focused in a plane other than that of the trabecular meshwork), laser power, slit lamp design, and patient factors.…”

“…Damage sustained by these lenses during SLT can obscure the physician’s view and complicate treatment, requiring frequent repositioning and lens rotation to complete the procedure 6,7 . Furthermore, the authors have observed that some lenses used within this institution sustain more damage on their reflective coating than others.…”

“…Prior reports describing reduced therapeutic efficacy due to the laser-incurred damage on disposable SLT gonioscopy lenses have been limited to small studies with fewer than 50 eyes 5,6,8 . Larger, more comprehensive studies to investigate this further and assess the impact on clinical outcomes as well as risk factors are lacking.…”

“…Prior reports describing reduced therapeutic efficacy due to the laser-incurred damage on disposable SLT gonioscopy lenses have been limited to small studies with fewer than 50 eyes. 5,6,8 Larger, more comprehensive studies to investigate this further and assess the impact on clinical outcomes as well as risk factors are lacking. Here we (a) identify potential factors that lead to increased damage to the reflective coating and (b) determine associations between the magnitude of lens damage and treatment outcomes.…”