In this special episode recorded at ESCRS, Prof. Gus Gazzard speaks with Dr. Neeru Vallabh and Mr. Dirk Mühlhoff about how excimer laser technology is transforming glaucoma treatment. They discuss Excimer Laser Trabeculostomy (ELT), which uses ultraviolet light to create precise, non-thermal microchannels in the trabecular meshwork, improving natural fluid outflow. The conversation highlights how this laser, long used in refractive surgery, is now offering a safe, minimally invasive option for glaucoma patients.
The Interventional Glaucoma Podcast
Episode 17: Excimer fundamentals
Key Takeaways
- ELIOS ELT in glaucoma: Creates ~200μm microchannels in the trabecular meshwork to restore natural outflow and lower IOP.
- Durability: Channels remain open long-term (up to 8 years observed).
- Safety: UV light absorbed locally—no risk of stray beams; no need for goggles.
- Ease of use: Quick learning curve; can be performed through a standard phaco incision.
- Clinical outcomes: Mean IOP ~15 mmHg with reduction of 1–2 medications at 12 months.
- Pigmentation: Works equally well in pigmented and non-pigmented angles.
- Beyond ophthalmology: Similar excimer technology used in vascular laser atherectomy.
- Overall: A safe, precise, and minimally invasive advancement in MIGS.
Guests
Prof. Gus Gazzard
Professor Gus Gazzard is Director of Surgery at Moorfields Eye Hospital and Professor in Ophthalmology, Glaucoma Studies at UCL London. He has joined the Glaucoma Research Society as one of the top 100 glaucoma researchers in the field and is leading author of multiple publications on MIGS surgery. He was voted in the World’s Top 10 Most Influential Ophthalmologists for several years.
Ms Neeru Vallabh
Neeru Vallabh MBBS, PhD, FRCOphth is a glaucoma specialist at Liverpool University Hospital NHS Foundation Trust and Clinical Senior Lecturer at the University of Liverpool. She is a committee member of the UK Eye Genetics Group, section editor for Eye, and Next Generation Partner in the European Glaucoma Society. Her research focuses on clinical trials, imaging in glaucoma surgery, mitochondrial dysfunction, and genetics.
Mr Dirk Mühlhoff
Since 2025, he has been Managing Director/CEO of MLase GmbH, specializing in excimer lasers for ophthalmology and laser atherectomy. Before, he was holding several R&D and management positions at Carl Zeiss Meditec AG where he spearheaded the development of refractive surgery technology including the SMILE procedure. He also serves on the Board of Directors at Allotex S.p.A., supporting the development of allogenic collagen implants for presbyopia treatment. Dirk Muehlhoff has been active in professional organizations, including serving from 2015–2025 on the European Executive Committee of AECOS. He is the inventor or co-inventor on 56 patent families spanning laser-scanning ophthalmoscopy, digital projection technology, and refractive surgery. His career spans over 25 years in advancing ophthalmic laser technologies.
Additional Resources
Follow Prof Gus Gazzard on Social:
Professor Gus Gazzard | LinkedIn
Follow Ms Neeru Vallabh on Social:
Ms Neeru Vallabh | LinkedIn
Follow Mr Dirk Mühlhoff on Social:
Mr Dirk Mühlhoff | LinkedIn
Episode 19: ELIOS – What does the data tell us?
In this episode of the Interventional Glaucoma Podcast, our experts Prof. Gus Gazzard, Prof. Cédric Schweitzer and Dr. Marc Töteberg-Harms discuss the evidence, safety, and long-term data behind interventional glaucoma
Episode 18: Health Economics in Interventional Glaucoma
In this episode, Prof. Gus Gazzard talks with Dr. Marc Töteberg-Harms and Dr. Timothy Hamann about the cost-effectiveness and ethical importance of MIGS in interventional glaucoma.
Episode 16: Integrating Glaucoma Surgery into Your Phaco Routine
In this episode, Prof. Verena Prokosch and Ms. Nishani Amerasinghe explore integrating MIGS with cataract surgery, highlighting how laser trabecular procedures enhance outcomes when combined with phacoemulsification.