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Argon laser trabeculoplasty (ALT) in the under 40 crowd

Question:

Hi Curt: Dr. Robert Ritch responds: c…@journyx.com wrote: >My question is why does ALT affect patients under 40 differently?

The pigment is in the inner meshwork instead of the outer meshwork >And also why is pigmentary glaucoma different in this instance?

same answer >I’m 34 (treated since 27) have been recommended for ALT, am having >trouble getting IOP below 22 with timoptic and alphagan.

What about Ocuserts? We find Propine may work well in pigmentary glaucoma. >I’m showing some damage in the same eye which has the most >elevated pressure (28 last time under timoptic and alphagan), >and don’t know whether I have pigmentary glaucoma or not but I >know it’s open angle.

It’s very important to know. >  I may participate in a local 3 year memantine study >if possible.  Do half the people get placebos in those things?

yes

Response:

From the FAQ, I see this: > In general, ALT is more effective in older individuals, except in > pigmentary glaucoma, where younger patients tend to have a better > pressure-lowering response. > ALT produces borderline or poor results in most other > open-angle glaucomas. Aside from pigmentary glaucoma, it should > NOT be performed in patients under age 40, as it may worsen the > condition.

My question is why does ALT affect patients under 40 differently? And also why is pigmentary glaucoma different in this instance? I’m 34 (treated since 27) have been recommended for ALT, am having trouble getting IOP below 22 with timoptic and alphagan. I’m showing some damage in the same eye which has the most elevated pressure (28 last time under timoptic and alphagan), and don’t know whether I have pigmentary glaucoma or not but I know it’s open angle. I pushed for more drops to delay surgery and am now taking Xalatan at 7am with Timoptic and Alphagan Pilocarpine 1/2% at 7pm with Timoptic and Alphagan. (Actually I usually delay the pilocarpine until i’m about to go to sleep because it blinds me and gives me a headache.) Have not had a pressure check yet to check the effectiveness. I restarted myself on Gingko Biloba/Gotu Kola liquid (are only the pills effective?)  I may participate in a local 3 year memantine study if possible.  Do half the people get placebos in those things? __________________________________________________________________    Web-Based Time Tracking                      journyx WebTime    is FREE for 60 Days at                        (512)834-8888  http://journyx.com/wts.html                    c…@journyx.com —————————————————————— —–== Posted via Deja News, The Leader in Internet Discussion ==—– http://www.dejanews.com/   Now offering spam-free web-based newsreading

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