Abstract
PurposeTo assess the efficacy of selective laser trabeculoplasty (SLT) following failed phacoemulsification cataract extraction combined with excimer laser trabeculotomy (phaco-ELT).MethodsRetrospectively, the medical records of patients with primary or secondary open-angle glaucoma or ocular hypertension who underwent SLT between January 2001 and February 2015 by one surgeon at a single center after a failed phaco-ELT were evaluated. Exclusion criteria were: angle-closure glaucoma, optic nerve atrophy due to disease other than glaucoma, and additional glaucoma procedures between phaco-ELT and SLT. The main outcome measures were time to failure and Kaplan–Meier survival. Complete success was defined as a reduction of intraocular pressure (IOP) of > 3 mmHg and > 20% compared to baseline, and the number of AGM ≤ baseline.ResultsA total of 23 eyes of 21 subjects were included. Baseline IOP was 19.7 (range, 19.1–22.7) mmHg, and the number of AGM at baseline was 2.5 (range, 1.9–2.9). Median time to failure after SLT was 7.2 (range, 6.6–7.8) months. The number of antiglaucoma medications did not change during that time.ConclusionsIn eyes in which the IOP is no longer controlled following phaco-ELT, SLT could be an option to slow disease progression or prolong time until incisional filtration surgery. However, time to failure after SLT is limited. Thus, close follow-up visits are necessary in order to not delay an incisional surgery.
Highlights
Glaucoma is one of the leading causes of irreversible blindness worldwide [1]
Definition of failure for phaco-Excimer laser trabeculotomy (ELT) was: an individual target pressure was not reached at two consecutive visits or the glaucoma was further progressing besides an intraocular pressure (IOP) within the target range
Phaco-ELT was performed on 283 eyes of 223 patients between January 2001 and February 2015 by one surgeon at the Department of Ophthalmology at the University Hospital Zurich, Switzerland
Summary
Glaucoma is one of the leading causes of irreversible blindness worldwide [1]. Progressive neuro-degenerative disease characterized by progressive loss of retinal nerve fiber tissue leading to deterioration of the visual field and, to blindness [2]. Disease progression and, vision loss can be slowed down or even prevented. The only evidence-based treatment is the lowering of intraocular pressure (IOP) [3, 4]. Topical IOP lowering medications (AGM) are the first-line therapy. During the course of the treatment, multiple drugs are required to reach a target pressure, which sufficiently slows down progression
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