A Comparison of 180 Degrees of Treatment with Diode Laser Trabeculoplasty in Primary Open-Angle Glaucoma and Exfoliation Glaucoma: A Short-Term Study of 22 Patients

Abstract

Purpose: Evaluation of diode laser trabeculoplsaty (DLT) efficacy in lowering intraocular pressure (IOP) in patients with open-angle glaucoma and the differences between primary open-angle glaucoma (POAG) and exfoliation glaucoma (XFG) after it; estimation of the shortest period after DLT when a decrease of IOP can be detected; estimation of the shortest period in achieving a maximum IOP decreases after which no further changes could be expected. Materials and Methods: A three-month, open-labeled, controlled, prospective study on the IOP-lowering efficacy of DLT in patients with POAG and XFG was performed between November 2007 and January 2008. Thirty-one eyes (POAG 19, XFG 12) were enrolled. Results: Only 1 out of 31 eyes failed to show an IOP decrease after use of DLT until day 90 of the follow-up, while the mean IOP decrease was 31.6% (POAG 24.03%, p < 0.01 and XFG 39.35%, p < 0.01). In XFG, the IOP decrease was 15.3% greater than in POAG (p = 0.002). POAG on day 7 showed a 19.1% IOP decrease from the baseline, and the XFG IOP decrease was 31.5% from the baseline. There were no statistical differences between IOP values on day 30 and day 90 in either POAG (p = 0.56) or XFG (p = 0.84). Conclusions: The DLT outcome could be predicted as early as day 7 of the follow-up, and the maximum IOP decrease after DLT could be evident on day 30. This study suggests that diode laser trabeculoplasty is an effective and safe mode of treatment for eyes with open-angle glaucoma, and its outcome may be predicted earlier than previously thought.