Frequency-doubled neodymium yttrium aluminum garnet (Nd:YAG) laser trabeculoplasty as adjuvant therapy for open-angle glaucomas

Abstract

The thermal frequency-doubled Nd:YAG (neodymium: yttrium-aluminum-garnet) laser was used sparingly for trabeculoplasty. Our goal was to assess the efficacy and safety of frequency-doubled Nd:YAG laser trabeculoplasty as an adjunct therapy to anti-glaucoma medications in open-angle glaucoma. Laser trabeculoplasty was performed on 41 eyes of 22 adults with open-angle glaucomas using a thermal frequency-doubled Nd:YAG laser (Green laser photocoagulator GYC-500® 532 nm, Nidek, Japan). To assess the laser’s effectiveness, patients were monitored for intraocular pressure (IOP) reduction, control, and complications at 1 hour, 1 week, and then monthly for a year. Primary open-angle glaucoma was the most common diagnosis in 31 (75.6%) eyes. The pre-laser baseline IOP was 18.87±3.66 mmHg. The mean IOP was 14.9±2.54 mmHg at Week 1 (p = 0.000), 14.65±2.50 mmHg at Month 1, 14.53±2.60 mmHg at Month 3, 15.85±2.30 mmHg at Month 6, and 15.14±2.17 mmHg at Month 12 (p=0.000). A significant percentage reduction in IOP was achieved at 1, 3, 6, and 12 months: 21.78%, 22.48%, 16.73%, and 18.53%, respectively. Patients used an average of 2.73±1.00 topical drugs before laser treatment. There was a significant reduction in medicines after laser treatment on all occasions, at 1, 3, 6, and 12 months (p = 0.000). Complications included some degree of peripheral anterior synechiae (PAS) in 20 (51.3%) eyes; an IOP spike in one patient only, bilaterally (5.1%) at 1 hour after therapy; and mild anterior uveitis in four (9.75%) cases. To summarize, frequency-doubled Nd:YAG laser trabeculoplasty is a safe and effective adjuvant therapy for open-angle glaucoma that reduces intraocular pressure and medication use.