SLT is an outpatient laser used to selectively target the pigmented trabecular meshwork cells in the angle of the eye. Despite research ⦠Video  Specialty: Multispecialty. Selective laser trabeculoplasty (SLT) was launched in 1998 by Latina et al. With more recognition and emphasis placed on the diurnal nature of IOP fluctuation, SLT’s effect on possibly blunting the pressure curve should be investigated. Send this article to a friend by filling out the fields below: This video provides a brief introduction to selective laser trabeculoplasty (SLT) for treating open-angle glaucoma. The corneal thinning persisted long-term in these cases.[44]. A common laser treatment for glaucoma is called selective laser trabeculoplasty, or SLT. The literature does contain case series of pigmentary glaucoma patients who have experienced sustained post-SLT IOP spikes, however. Argon laser therapy for open-angle glaucoma: a pilot study. Learn what to expect after glaucoma surgery, the precautions you should take, and the tools that youll need for a successful recovery and get one step closer to better, clearer vision. From Kahook's Essentials Of Glaucoma Therapy. Further studies will clarify its role in terms of longer-term follow-up, repeatability, and usefulness in secondary glaucomas. [43] Four case reports were published indicating corneal edema, haze, and thinning. In this interview, Dr. Mark Latina, inventor of selective laser trabeculoplasty (SLT), explains how the technology and approach were conceived, the presumed mechanism of action, and which glaucoma patients are ⦠[42] One study described more patients experiencing pain during SLT when a larger circumference of the angle was treated compared to a smaller treatment area. Hi, @azpowells â wanted to let you know I moved your post here, as it was related to Selective Laser Trabeculoplasty (SLT) and I thought it would be helpful for members to find the information on this all in one place. Stay up-to-date with the latest news about glaucoma, treatments, and research. The most commonly reported adverse reaction after SLT is an early postlaser IOP elevation. In a post hoc analysis of the selective laser trabeculoplasty (SLT) treatment arm of the Laser in Glaucoma and Ocular Hypertension (LIGHT) trial, repeat SLT maintained IOP at or below the target in medication-naïve eyes with primary open-angle glaucoma (POAG) and ocular hypertension (OHT) that required retreatment. SLT is relatively straightforward to perform and may yield benefits even when performed more than once. A common laser treatment for glaucoma is called selective laser trabeculoplasty, or SLT. It can be repeated, added on top of existing drop regimens, and done for patients that have received trabeculectomy. Side effects from performing SLT tend to be mild and self-limited; however, transient pressure spikes shortly after SLT have been reported, especially in eyes with heavy trabecular meshwork pigment. Last reviewed on From 2.5 to 5⦠A randomized, prospective study comparing selective laser trabeculoplasty with latanoprost for the control of intraocular pressure in ocular hypertension and open angle glaucoma. Patients and Methods: This was a database analysis (Lausanne Laser Trabeculoplasty Registry) of patients who had SLT between 2015 and 2017. One study of SLT in diabetic versus nondiabetic eyes showed similar levels of efficacy. Selective laser trabeculoplasty (SLT) was introduced as a safe, effective treatment for primary open-angle glaucoma (POAG) more than 20 years ago, and researchers have since touted it as not just a tool to stave off glaucomatous damage, but as a first-line therapy, even before drops, for many patients. Results of argon laser trabeculoplasty versus topical medications. 4K and HD video ready for any NLE immediately. Sponsor opinions are not reflected on our website. Allergy & Immunology. Song J, Lee PP, Epstein DL, et al. Selective Laser Trabeculoplasty (SLT) is becoming a widely accepted treatment option in glaucoma treatment. Video clip id 1064102686. 1) Harasymowycz PJ, Papamatheakis DG, Latina M, et al. SALT Trial: Steroids after Laser Trabeculoplasty: Impact of Short-Term Anti-Inflammatory Treatment on Selective Laser Trabeculoplasty Effiacy. In this interview, Dr. Mark Latina, inventor of selective laser trabeculoplasty (SLT), explains how the technology and approach were conceived, the presumed mechanism of action, and which glaucoma patients are best candidates for the treatment. The topic today involves the elevation of primary Selective Laser Trabeculoplasty, or SLT, from a âside considerationâ to a therapeutic approach that is much more common. [45] The SALT Trial examined whether short-term use of topical nonsteroidal anti-inflammatory drugs (NSAIDs) or steroid therapy affected the efficacy of SLT[46]. One published article reports that repeat 360-degree SLT lowers pressure equally well to the first SLT treatment when performed at least 6 months after the original treatment has failed. The majority of patients with a significant pressure elevation post-SLT respond well to additional topical medications and/or watchful waiting, with resolution of the pressure elevation. Selective laser trabeculoplasty is a laser treatment to treat glaucoma. Selective laser trabeculoplasty (SLT) was introduced as a safe, effective treatment for primary open-angle glaucoma (POAG) more than 20 years ago, and researchers have since touted it as not just a tool to stave off glaucomatous damage, but as a first-line therapy, even before drops, for many patients. Short-term effect of argon laser trabeculoplasty: studies of mechanism of action. July 19, 2019, Was this helpful? STUDY IN BRIEF. This was a retrospective clinical study. Selective Laser Trabeculoplasty (SLT) is a safe and painless procedure that can effectively reduce the eye pressure and replace some or all of your drops in one session. Comparison of the morphologic changes after selective laser trabeculoplasty and argon laser trabeculoplasty in human eye bank eyes. Hi, @azpowells – wanted to let you know I moved your post here, as it was related to Selective Laser Trabeculoplasty (SLT) and I thought it would be helpful for members to find the information on this all in one place. For instance, lower energy levels, fewer laser spots, or treating a smaller circumference of the angle at each session should be considered. Groth SL, Albeiruti E, Nunez M, et al. It is used when eye drop medications are not lowering the eye pressure enough or are causing significant side effects. Selective Laser Trabeculoplasty is an improvement over conventional ALT by eliminating thermal damage of the trabecular meshwork architecture. Some of these patients required trabeculectomy shortly after SLT to control the IOP. Get a 10.800 second selective laser trabeculoplasty. Selective laser trabeculoplasty (SLT) Introduction This leaflet is for patients undergoing selective laser trabeculopasty (SLT) Clinical indications of SLT Glaucoma can sometimes be treated successfully with medications to lower the pressure in the eye. Juzych MS, Chopra V, Banitt MR, et al. Pizzimenti JJ, Nickerson MM, Pizzimenti CE, et al. Hong BK, Winer JC, Martone JF, Wand M, Altman B, Shields B. Repeat selective laser trabeculoplasty. The treating ophthalmologist should monitor the post-SLT IOP especially carefully in these patients. Bylsma SS, Samples JR, Acott TS, Van Buskirk EM. Patients who cannot afford glaucoma medications. Some study patients received a prophylactic pressure-lowering eye drop perioperatively (usually apraclonidine 0.5% or brimonidine tartrate 0.2%), whereas others did not. The effect of selective laser trabeculoplasty on intraocular pressure in patients with intravitreal steroid-induced elevated intraocular pressure. The topic today involves the elevation of primary Selective Laser Trabeculoplasty, or SLT, from a “side consideration” to a therapeutic approach that is … At OSN New York, Robert Noecker, MD, MBA, discusses the safety and efficacy of laser trabeculoplasty in lowering IOP, and considers the use of the procedure as first line therapy in glaucoma patients. Selective Laser Trabeculoplasty (SLT) for glaucoma is a new procedure performed to lower intraocular pressure (IOP). This means the fluid in your eye flows through the channels better, reducing the pressure in your eye. This is Malik Kahook from The University of Colorado and this is the second edition of one slide in 5 minutes. Ruddat MS, Alexander JR, Samples JR, et al. Dr. Feulner can now lower pressure that can help a patient avoid a more invasive glaucoma surgery. Repeat SLT was at least as effective as initial SLT treatment. Shibata M, Sugiyama T, Ishida O, et al. Selective laser trabeculoplasty as initial and adjunctive treatment for open-angle glaucoma. [18][24][42] There is a suggestion that of patients who felt pain with SLT, the pain level was significantly lower when compared with patients undergoing ALT. Using a low-energy, Q-switched, frequency doubled Nd:YAG laser emitting at 532 nm with a pulse duration of 3 nanoseconds, researchers demonstrated isolated destruction ⦠Laser in Glaucoma and Ocular Hypertension (LiGHT) trial. Your doctor beams a highly targeted low-level laser at just the spots where thereâs pressure. Patients who would like to reduce the number of glaucoma medications they are taking. Worthen DM, Wickham MG. Argon laser trabeculotomy. The trial concluded that eyes treated with steroid or NSAID drops after SLT had significantly better IOP reduction at 12 weeks compared to placebo treatment. Yes This leads to increased drainage of fluid from the eye and a lowering of the eye pressure. The full effects of the laser treatment may not be apparent until 1-2 months after the laser treatment. Selective laser trabeculoplasty. Video: Selective Laser Trabeculoplasty (SLT) Selective Laser Trabeculoplasty, or SLT, is a form of laser surgery that is used to lower intraocular pressure in glaucoma. Paper presented at: Annual Meeting of the Association for Research in Vision and Ophthalmology; May 2005; Fort Lauderdale, FL. More studies addressing the efficacy of SLT in normal tension glaucoma, particularly with regard to diurnal fluctuation, are also needed. Ophthalmology, 2019 Nov;126(11):1511-1516. In ⦠Download PDF. Argon laser trabeculoplasty (ALT) was introduced by Wise and Witter in 1979 for the treatment of medically uncontrolled glaucoma. Presentation #PO108. To determine the effectiveness and safety of selective laser trabeculoplasty (SLT) in young patients with primary open-angle glaucoma (POAG) and ocular hypertension (OHT). SLT has not been well studied in eyes in which ALT has not been considered useful. Selective laser trabeculoplasty (SLT) has been shown to be safe, well tolerated, and effective in intraocular pressure (IOP) reduction as therapy in several forms of open-angle glaucoma. Repeatability of selective laser trabeculoplasty (SLT). Methods . 2019 Feb;126(2):223-232. doi: 10.1016/j.ophtha.2018.09.037. Patients who do not tolerate glaucoma medications. Download footage now! Selective Laser Trabeculoplasty (SLT) Professor Gazzard led the worldâs largest, pivotal and highly influential study proving laser can be safely and effectively used for newly diagnosed open angle glaucoma patients: Selective Laser Trabeculoplasty (SLT) Br J Ophthalmol. Anderson RR, Parrish JA. This page was last edited on 5 September 2020, at 22:14. Nagar M, Ogunyomade A, O’Brart DP, et al. In a large cohort of eyes undergoing selective laser trabeculoplasty (SLT), Kuley et al. [30], Several studies suggest that SLT tends to be more successful in eyes with higher preoperative laser IOPs, at least when SLT success is measured as a percentage of IOP lowering from baseline. Inadequate visualization of the trabecular meshwork. The Zion Eye Institute is the first and only office in Southern Utah to have an in-house SLT laser for glaucoma. We appreciate support from corporations who believe in our The efficacy of 532 nm laser trabeculoplasty. One published study involving normal tension glaucoma patients who underwent SLT suggests that SLT does lower IOP in these patients to some degree and may also help reduce the amount of IOP fluctuation in this disease. The preservation of trabecular meshwork (TM) architecture and … [16][29][30], Although numerous studies report no anterior chamber reaction after SLT, some studies have described mild to moderate level of cells and flare. 2012,21:460-8 A restorative treatment approach. Presented at: American Academy of Ophthalmology Annual Meet-ing; November 2006; Las Vegas, NV. Post-laser anti-inflammatory treatment varies widely across practitioners, and although it had been suggested in the literature that using topical steroids short-term after SLT did not affect its success, the efficacy or necessity of this is not entirely agreed upon. Hoping members like @lizziemnz @ew100 will have some thoughts for you on whether you might consider doing SLT again as a maintenance procedure even with … All text, tables, images and figures or any other content submitted to KEOGT become the exclusive property of KEOGT. In these eyes, SLT was applied to the portions of the trabecular mesh-work that were visible on gonioscopy. Selective laser trabeculoplasty (SLT) Introduction This leaflet is for patients undergoing selective laser trabeculopasty (SLT) Clinical indications of SLT Glaucoma can sometimes be treated successfully with medications to lower the pressure in the eye. Allergy & Immunology. Given the fact that SLT has few adverse effects, and if it is shown over time to be successful with repeated treatments, it may help influence the glaucoma treatment paradigm in our aging patient population. LTP is used in the treatment of various open-angle glaucomas. Most studies have not found a relationship between the degree of trabecular meshwork pigmentation and the success rates of SLT. Martinez-de-la-Casa JM, Garcia-Feijoo J, Castillo A, et al. Patients with poor glaucoma medication compliance. It is generally a mild treatment which can be done in the doctorâs office. Van der Zypen E, Frankhauser F. Lasers in the treatment of chronic simple glaucoma. McIlraith I, Strasfeld M, Colev G, Hutnik CM. Studies addressing the interaction and possible synergy of SLT with medical glaucoma therapy also need to be performed. [33], A paucity of studies exists regarding race in relation to SLT success, but one article did find that SLT and ALT had similar success rates in black and white patients. Patients were divided into two subgroups consisting of patients without SLT treatment prior to surgery and patients who had been … Get a 12.560 second selective laser trabeculoplasty. Exclusion criteria were age below 40 years and diagnosis other than ocular hypertension and open-angle glaucoma. Clinical results of selective laser trabeculoplasty in open-angle glaucoma in Japanese eyes: comparison of 180 degree with 360 degree SLT. Selective Laser Trabeculoplasty (SLT) is a laser treatment that is used to lower the intraocular pressure of the eye. In SLT treatment, … Argon laser trabeculoplasty (ALT) was introduced by Wise and Witter in 1979 for the treatment of medically uncontrolled glaucoma. Pigmentary glaucoma: For SLT in pigmentary glaucoma, please see the following section. general diagnosis stock footage at 25fps. Selective laser trabeculoplasty (SLT) uses a short-pulsed laser to selectively target melanin within the TM without causing thermal damage to surrounding cells or tissues. Selective laser trabeculoplasty (SLT): If ALT doesnât work so well, your doctor may try this. Argon versus selective laser trabeculoplasty in the treatment of open angle glaucoma. For instance, it is not known whether SLT is safe and effective in eyes with uveitic, angle recession, or congenital glaucoma. Ophthalmologists can consider SLT as primary or adjunctive treatment for elevated IOP. Selective laser trabeculoplasty (SLT) is a procedure which can be performed to help reduce the intraocular pressure for patients with glaucoma. Transcript: The newest laser surgical option for the treatment of open angle glaucoma is called selective laser trabeculoplasty or SLT. A randomized clinical trial of selective laser trabeculoplasty versus argon laser trabeculoplasty in patients with pseudoexfoliation. The Glaucoma Laser Trial (GLT). Selective laser trabeculoplasty (SLT) complicated by intraocular pressure elevation in eyes with heavily pigmented trabecular meshworks. The exception to this was 3 reported patients with heavily pigmented trabecular mesh-work who had severe, prolonged IOP elevation after SLT and underwent trabeculectomy. Five-year follow up of selective laser trabeculoplasty in Chinese eyes. Selective Laser Trabeculoplasty (SLT) is a laser treatment that is used to lower the intraocular pressure of the eye. One case report is in the literature of self-limited hyphema occurring during SLT; this resolved spontaneously. Selective laser trabeculoplasty (SLT) is a commonly used office procedure to reduce intraocular pressure (IOP) in patients with glaucoma. My personal conclusion is that I should be offering more primary SLT to treatment naïve patients compared to what I have done in the past and I would welcome future exploration of adding SLT vs medications in patients already on one or two drops when treatment escalation is needed. These eyes tend to also require topical glaucoma medications to control the IOP. mission to educate glaucoma patients and speed a cure. Regarding aging, investigating the efficacy of SLT in patients of different ages would be helpful. 2006;90(12):1490-1494. In a trabeculoplasty procedure, a laser beam is applied to the drainage channels, which helps to unclog them. [24], Other adverse reactions from SLT are rare. These studies have included a small number of pigmentary glaucoma patients who have had similar SLT success rates when compared with patients with less trabecular meshwork pigment.[16][29]. 4K and HD video ready for any NLE immediately. The impact of anti-inflammatory therapy on IOP reduction following selective laser trabeculoplasty. Unpublished American Academy of Ophthalmology 2006 poster presentation. It is generally a mild treatment which is performed in an outpatient surgery center. More work needs to done regarding the long-term effect of SLT, as well as its repeatability. By submitting content you hereby irrevocably assign and agree to assign to KEOGT, free and clear of any restrictions or encumbrances, all of your rights, title and interest in and to the content submitted. Damji KF, Bovell AM, Hodge WG, et al. Ophthalmology Glaucoma, March/April 2020. Barkana Y, Belkin M. Selective laser trabeculoplasty. Extended Video Transcript. Video Specialty: Multispecialty. It was initially indicated for open-angle glaucoma but has been proven to be efficacious for various types of glaucoma. Fortunately, angle scarring is seen in less than 3% of eyes treated with Selective Laser Trabeculoplasty (SLT). Am J Ophthalmol. Melamed S, Pei J, Epstein DL. Ho CL, Lai JS, Aquino MV, et al. Realini T. Selective laser trabeculoplasty: a review. At OSN New York, Robert Noecker, MD, MBA, discusses the safety and efficacy of laser trabeculoplasty in lowering IOP, and considers the use of the … Werner M, Smith WM, Doyle JW. Active uveitis or history of uveitis (relative contraindication; see, Traumatic glaucoma (relative contraindication; see, Congenital or early childhood glaucoma (relative contraindication; see, Primary or secondary angle-closure glaucoma (relative contraindication; see. SLT is a procedure that is gaining increasingly wider popularity due to its efficacy, favorable side- effect profile, technical ease, and potential repeatability. One study described IOP lowering after SLT in eyes with chronic primary angle closure that had already been treated with laser iridotomy. Similar effects of selective laser trabeculoplasty and prostaglandin analogs on the permeability of cultured Schlemm canal cells. In several studies,[18][21][32] use of a prophylactic pressure-lowering eyedrop did not seem to affect the rate of postlaser pressure elevation. ... By comparison, selective laser trabeculoplasty (SLT) is designed to lower IOP after a single outpatient procedure. Epub 2010 Jun 8. Selective laser trabeculoplasty versus medical therapy as initial treatment of glaucoma; a prospective, randomized trial. Selective vs argon laser trabeculoplasty: hypotensive efficacy, anterior chamber inflammation, and postoperative pain. [3] Because ALT may âclose doorsâ on future MIGS options patients who would benefit from Laser Trabeculoplasty should generally opt for SLT or MLT where available. Download footage now! The Zion Eye Institute is the first and only office in Southern Utah to have an in-house SLT laser for glaucoma. Selective Laser Trabeculoplasty versus Argon Laser Trabeculoplasty in Glaucoma Patients Treated Previously with 360° Selective Laser Trabeculoplasty: A Randomized, Single-Blind, Equivalence Clinical Trial Ophthalmology. Hyphema following selective laser trabeculoplasty. Currently, there is some disagreement on whether each laser session should involve treatment of 90, 180 or 360 degrees of the angle although more recent practice patterns have gravitated towards treating 360 degrees. Hoping members like @lizziemnz @ew100 will have some thoughts for you on whether you might ⦠In all published studies, the anterior chamber inflammation was self-limited and resolved without long-term sequelae. The mechanism by which SLT 2) Thomas JV, Simmons RJ, Belcher CD 3rd. . Selective Laser Trabeculoplasty Video From Rendia. Dr. Feulner can now lower pressure that can help a patient avoid a more invasive glaucoma surgery. Material and Methods The article provides a review of the literature from PubMed and clinical experience. There is some minor evidence that the effects of SLT in exfoliation glaucoma patients may last somewhat longer than in primary open-angle glaucoma patients. 8. Nagar M. SLT—effect of enhancement and repeatability on IOP. Wise JB, Witter SL. Choose from a wide range of similar scenes. Lai J, Bournias TE. Also, the effect of the number of applications and pulse duration has not been well studied. View Video : Laser PI : Narrow angles/ Angle closure glaucoma : This is a common condition especially among Asians. Selective laser trabeculoplasty for primary angle clo-sure with persistently elevated IOP after iridotomy. Purpose . Selective Laser Trabeculoplasty is an improvement over conventional ALT by eliminating thermal damage of the trabecular meshwork architecture. This is "SLT Selective Laser Trabeculoplasty treatment" by Dan Lindfield: Ophthalmologist on Vimeo, the home for high quality videos and the people who… In: Epstein DL, Alling-ham RR, Schuman JS, eds. SLT works by applying selective photothermolysis of the pigmented trabecular meshwork cells. Harasymowycz PJ, Papamatheakis DG, Latina M, et al. Choose from a wide range of similar scenes. Please enter your question in the Search box below. Rubin B, Taglienti A, Rothman RF, Marcus CH, Serle JB. Selective Laser Trabeculoplasty: An Update Jeffrey B. Kennedy, MD, Jeffrey R. SooHoo, MD, Malik Y. Kahook, MD, and Leonard K. Seibold, MD Abstract: Selective laser trabeculoplasty (SLT) is an effective treatment option for thereductionof intraocular pressure(IOP) in patientswithocu-lar hypertension or open-angle glaucoma. Method of Treatment for Selective Laser Trabeculoplasty, Indications and Contraindications for Selective Laser Trabeculoplasty, Selective Laser Trabeculoplasty Versus Argon Laser Trabeculoplasty, Selective Laser Trabeculoplasty After Failed Argon Laser Trabeculoplasty, Selective Laser Trabeculoplasty Versus Glaucoma Medications, Repeatability of Selective Laser Trabeculoplasty, Selective Laser Trabeculoplasty’s Effect in Specific Patient Subgroups, Degree of Trabecular Meshwork Pigmentation, Level of Preoperative Intraocular Pressure, Adverse Effects of Selective Laser Trabeculoplasty, Early Postoperative Intraocular Pressure Elevation. It can be used at any stage of the glaucoma continuum, but it is usually more effective in ocular hypertension, mild and moderate glaucoma. Melamed S. Argon laser trabeculoplasty: how does it work? The Glaucoma Laser Trial Research Group. Fortunately, the vast majority of reported adverse reactions to SLT have been transient and without lasting sequelae. Br J Ophthalmol. Establishing optimal treatment parameters for SLT would help the thousands of ophthalmologists who currently perform this treatment. Since its introduction in 2001, selective laser trabeculoplasty (SLT) has significantly altered the traditional stepped treatment regimen for glaucoma management.Once reserved for eyes failing maximal medical therapy, trabeculoplasty is now offered significantly earlier in the treatment paradigm, ⦠J Glaucoma. Comparison of selective laser trabeculoplasty vs. medical therapy from intial therpay for glaucoma or ocular hypertension. More research is needed to determine SLT’s usefulness in long-term follow-up, in certain secondary glaucoma populations, and in terms of repeatability. [16], A few studies have noted small numbers of patients who experienced pain with SLT treatment. The ideal laser for this targeted outcome is the Q-switched frequency-doubled (532 nm) Nd:YAG laser from Quantel Medical, which pro- Currently, all therapy for glaucoma is directed at lowering eye pressure, but the fundamental problem in glaucoma is the degeneration of the optic nerve fibers necessary for vision. 2010 Aug;150(2):254-64. doi: 10.1016/j.ajo.2010.03.012. Laser trabeculoplasty (LTP) is the application of a laser beam to burn areas of the trabecular meshwork, located near the base of the iris, to increase fluid outflow. A multicenter, randomised controlled trial: design and methodology. Realini T, Hettlinger CJ. Video clip id 1063119532. ... By comparison, selective laser trabeculoplasty (SLT) is designed to lower IOP after a single outpatient procedure. During the SLT procedure, your doctor directs a low frequency laser beam into the trabecular meshwork, which is the primary drainage region of the eye. Selective laser trabeculoplasty (SLT) is a procedure which can be performed to help reduce the intraocular pressure for patients with glaucoma. Lancet. Katz LJ, Steinmann WC, Marcellino GR; The SLT MED Study Group. The outflow of aqueous humor is then enhanced and the IOP is lowered. SLT can also reduce ⦠Trabecular cell division after argon laser trabeculoplasty. Laser energy is delivered to the drainage tissue of the eye (called the trabecular meshwork). 2018 May;102(5):593-598. Selective laser trabeculoplasty in phakic and pseudophakic eyes. SLT can be useful as primary or adjunctive therapy for elevated IOP. Selective laser trabeculoplasty versus argon laser trabeculoplasty: a prospective randomized clinical trial. 1999;83(6):718-722. Hodge WG, Damji KF, Rock W, et al. Glaucoma with medically uncontrolled IOP. Latina MA, Park C. Selective targeting of trabecular meshwork cells: in vitro studies of pulsed and CW laser interactions. 2. In this interview, Dr. Mark Latina, inventor of selective laser trabeculoplasty (SLT), explains how the technology and approach were conceived, the presumed mechanism of action, and which glaucoma patients are â¦
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