What lasers would we use to treat open-angle glaucoma (OAG)?

• A. SLT/ALT, cyclophotocoagulation
• B. YAG capsulotomy
• C. Excimer laser corneal reshaping
• D. None of the above

Answer: (A)

Open-angle glaucoma treatment with lasers focuses on two goals: increasing drainage through the trabecular meshwork and reducing the production of aqueous humor. Selective laser trabeculoplasty uses a laser to target the trabecular meshwork, improving outflow and lowering intraocular pressure. Argon laser trabeculoplasty achieves a similar outflow boost by remodeling the meshwork. Cyclophotocoagulation, on the other hand, applies laser energy to the ciliary body to decrease aqueous production, which helps lower pressure when outflow-targeted options aren’t enough. YAG capsulotomy is for clearing a cloudy posterior capsule after cataract surgery, not glaucoma, and excimer laser corneal reshaping is a refractive procedure, not a glaucoma treatment. So the laser options used for open-angle glaucoma are the outflow-enhancing lasers and the ciliary body–ablating laser.