Laser-induced Damage to Disposable Single-mirror Trabeculoplasty Lens During Selective Laser Trabeculoplasty

To demonstrate disposable trabeculoplasty lens damage after routine selective laser trabeculoplasty (SLT) for primary open-angle glaucoma.

Disposable single-mirror laser lenses were used to perform SLT in 2 patients with primary open-angle glaucoma. Images of the single-use mirrors were taken before and after treatment.

One lens showed heavy focal loss of reflectivity of its mirror with SLT settings of 0.8 to 0.9 mJ × 97 shots on a patient with a lightly pigmented angle. Aiming beam splashing or loss was noted after most shots. The second lens showed much less damage with 0.6 mJ × 90 shots in a heavily pigmented angle.

Although single-use Gonio lenses have gained popularity for their role in infection control and elimination of wear and tear of reusable lenses, our cases show that damage occurs to the silver mirror because of high laser fluence, interfering with proper aiming and possibly diminishing delivered energy and treatment efficacy.