Subthreshold lasers are non-damaging to eye anatomy, says Dr. Karth.
"Nearly every other therapy we use — injections to treat DME and sur-
gery to treat glaucoma — carry inherent risks," he says. "This is an ultra-
low-risk laser modality that produces low to no pain, making it very com-
fortable for the patient."
Added clinical benefit
The latest laser procedures offer potentially significant improvements
to patient care, says Dr. Karth. However, he says, laser therapies are
not the panacea to treating eye disease. "You wouldn't perform a
micropulse laser procedure on a raging diabetic with huge edema and
leave them alone for 3 months," explains Dr. Karth. "These proce-
dures work best as adjunct therapies to injections in patients with
macular disease and to drops, or even surgery, in glaucoma patients."
He points to the speed and degree of effectiveness of current eye
disease treatments as one of the main reasons for the lack of wide-
spread adoption of therapeutic lasers. "When a month's worth of
bevacizumab injections dramatically reduces macular thickness in
patients with DME, you want to administer more injections," he says.
"This obvious positive result reinforces that the therapy is working.
You often don't get that same effect with subthreshold lasers,
although the data show the technology is effective."
Still, he believes therapeutic lasers can optimize the treatment of
various eye conditions. Ideally, says Dr. Karth, "Lasers should be used
to achieve better clinical outcomes, while reducing the burden of
other riskier interventions."
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