Effect Of Selective Laser Trabeculoplasty Research Articles

Effect of Selective Laser Trabeculoplasty on the Fellow Eye.

Determine if selective laser trabeculoplasty (SLT) affects the fellow eye's intraocular pressure (IOP). A retrospective review of 76 pairs of eyes from 76 adult glaucoma patients who underwent SLT in one eye with at least 2 months between treatments were evaluated for IOP and medication reduction in the untreated fellow eye. Success was defined as ≥20% IOP reduction or ≥1 medication reduction without any additional IOP lowering procedures or medication. The primary outcome measures were success, IOP, and medication reduction in the untreated fellow eye at 6 months. At 6 months after SLT treatment, 48.7% (38/76) treated eyes and 36.8% (28/76) untreated fellow eyes met success criteria. IOP reduction in the treated eye was 2.6 ± 5.8 (14.1%; p < 0.002) and 0.8 ± 4.3 (5.1%, p = 0.122) in the fellow eye. The fellow eye was significantly more likely to meet success criteria if the treated eye was successful [odds ratio (OR): 6.00, 95% confidence interval (CI) (2.11-17.06), p < 0.002]. After a unilateral treatment with SLT, over one-third of the fellow eyes experienced either ≥20% IOP reduction or medication reduction. Additionally, fellow eyes were six times as likely to meet success criteria if this was observed in the treated eye. These findings may support the proposed biochemical mechanism for the therapeutic action of SLT. The implication for clinicians is that SLT treatment in one eye may allow the fellow eye to benefit and provide a prediction on the fellow eye's response without subjecting both eyes to the rare but present complications of SLT. Hirabayashi M, Mellencamp E, Duong S, et al. Effect of Selective Laser Trabeculoplasty on the Fellow Eye. J Curr Glaucoma Pract 2023;17(4):175-177.

Factors affecting the hypotensive effect of selective laser trabeculoplasty in primary open-angle glaucoma

This study analyzes the influence of various factors on the hypotensive effect of selective laser trabeculoplasty (SLT) in patients with primary open-angle glaucoma (POAG). A retrospective study of the SLT effect was performed in 582 patients (756 eyes; mean age - 71.9±9.5 years) with POAG stages I-III. The level of intraocular pressure (IOP) decrease was assessed at 1 day, 1, 3, 6, and 12 months after SLT. The relationship between the hypotensive effect and age, gender, glaucoma stage, initial IOP level, number and type of instilled drugs, presence of intraocular lenses, and the surgeon performing the intervention were analyzed. In the entire sample, the hypotensive effect of SLT after 1 day was 4.1±3.4 mm Hg, after 1, 3, 6, and 12 months - 3.7±4.8; 3.5±3.8; 3.1±3.4 and 2.3±3.8 mm Hg, respectively. The hypotensive effect of SLT was most dependent on the preoperative IOP level (R>0.64, p<0.05). No significant correlation was found between the hypotensive effect and the stage of POAG, gender, age, number of hypotensive drugs, phakia/aphakia, and the surgeon. A weaker hypotensive effect of SLT was found in eyes receiving monotherapy with α2-adrenoceptor agonists (p<0.03) and a combination of four drugs (p<0.02). SLT is an effective method of additional IOP reduction in POAG at any stage and with any hypotensive regimen. At the same time, the results of its use in real clinical practice indicate the need for more careful IOP control after the procedure, especially in eyes with POAG stage III, as well as in eyes without hypotensive therapy and on the maximum drop regimen.

Change in Intraocular Pressure after Selective Laser Trabeculoplasty in North Indian Primary Open Angle Glaucoma Patients: A Prospective Analytical Study

Introduction: Glaucoma is the second leading cause of blindness in the world. The only known modifiable risk factor for the onset and progression of glaucoma is Intraocular Pressure (IOP). There are a limited number of studies documenting the IOP-lowering effect of Selective Laser Trabeculoplasty (SLT) in Primary Open Angle Glaucoma (POAG) patients, especially within the North Indian population. Understanding the effect of SLT on IOP reduction in this population is crucial for the proper management of glaucoma patients. Aim: To study the IOP-lowering effect of SLT in North Indian POAG patients (who had not achieved target IOP on two or more antiglaucoma drugs) after a period of six months. Materials and Methods: A hospital-based, single-arm, prepost type of prospective analytical study was conducted at Lady Hardinge Medical College and associated hospitals in New Delhi, India, from January 2021 to June 2022. POAG patients aged 18 years or older, who had not achieved the target IOP while on two or more Antiglaucoma Medications (AGM), were given the option of treatment with SLT. A total of 33 eyes were considered for the study as per sample size calculations. PreSLT, IOP was recorded along with other baseline parameters. The SLT procedure was carried out according to the standard protocol. IOP was recorded during follow-ups at one week, one month, three months, and six months. The Friedman test was used to compare IOP values, with a significance level set at 0.05. Spearman correlation was employed to explore the correlation between baseline IOP and the change in IOP at six months. Results: A total of 33 eyes were included in the study. Of these, 28 (84.8%) eyes had advanced glaucoma, while 5 (15.2%) eyes had moderate glaucoma according to International Classification of Diseases, Tenth Revision (ICD-10) staging. Patients were on two or more commonly used AGMs, including prostaglandin analogues, beta blockers, alpha agonists, topical carbonic anhydrase inhibitors, and rho kinase inhibitors. The mean number of topical AGMs that patients were using was 3.03. The number and type of AGMs for each patient remained consistent pre and post-SLT throughout the study period. The mean IOP (baseline) was 16.39±2.73 mmHg, and after six months, the mean IOP was 13.86±1.99 mmHg. The mean IOP reduced by 2.53 mm Hg (15.44%). There was a strong negative correlation between baseline IOP and the change in IOP at six months, which was statistically significant (rho=-0.78, p-value&lt;0.001). Conclusion: The present study indicates that SLT can be considered an adjunctive treatment for lowering IOP in North Indian POAG patients. A strong negative correlation was found between baseline IOP and IOP at six months post-SLT, suggesting that a higher reduction can be expected in patients with elevated baseline IOP.

Selective Laser Trabeculoplasty as a Substitute for Medications in Patients with Mild-to-moderate Glaucoma in the Brazilian Public Health System.

Selective laser trabeculoplasty can be used as a substitute for medications in patients with mild-to-moderate glaucoma, reducing the cost of eye drop distribution in the Brazilian public health system. To observe the effectiveness of selective laser trabeculoplasty (SLT) as a substitute for eye drops in patients with open angle glaucoma in the Brazilian Public Health System. SLT was performed bilaterally after medication washout. This is a prospective interventional study comparing intraocular pressure (IOP) when using eye drops at baseline (post-washout), and at 12-month follow-up after SLT. Medication was added if the target IOP was not achieved, following the Brazilian Public Health System eye drops protocol, based on medication costs. Absolute (without eye drops) and qualified (with eye drops) success were measured with IOP ≤ 21, IOP ≤ 18, IOP ≤ 15 and IOP ≤ 12 mm Hg. Besides IOP evolution, the ability to reduce IOP (in %), and eye drops reduction were evaluated. Ninety-two eyes of 46 patients were included, 70 eyes with mild glaucoma and 22 with moderate glaucoma; the mean number of eye drops was 2.26±1.06 (82.6% were using a prostaglandin analogue), and post-washout IOP of 21.10±5.24 mm Hg. There was relative success at IOP ≤18 mm Hg, where the mild group had greater success than the moderate group (88.1% vs. 71.4%, P =0.824). The average IOP reductions were 23.04% and 25.74% at 6 and 12 months, respectively. The average number of eye drops was 1.02, with 1.1% using a prostaglandin analogue. Furthermore, 68.19% of the patients had a decrease in the quantity of eye drops used. SLT is effective in reducing IOP and replacing eye drops in patients in the Brazilian Public Health System. Moreover, there was a significant reduction in the use of prostaglandin analogues.

Селективная лазерная трабекулопластика (СЛТ) после антиглаукомной хирургии при развитой и далеко зашедшей первичной открытоугольной глаукоме

Purpose. To study the hypotensive effect of selective laser trabeculoplasty (SLT) treatment in cases of insufficient effectiveness or reduced hypotensive effect of glaucoma surgery in patients with moderate and advanced primary open-angle glaucoma (POAG). Material and methods. A retrospective study was conducted of 32 patients (32 eyes) with POAG after previous glaucoma surgery and uncompensated intraocular pressure (IOP), who underwent SLT due to the impossibility of reoperation. Changes in IOP were studied 1 day, 1, 3, 6 and 12 months after SLT. Results. After SLT, the IOP level decreased from 24.5±4.4 to 19.3±3.8 mm Hg after 1 day (p&lt;0.001), the hypotensive effect was 5.2±5.1 mm Hg (21.2% of the baseline IOP) and did not change significantly within 3 months after laser treatment. After 6 and 12 months, a decrease in the hypotensive effect was revealed compared with the primary response 1 day after SLT (3.0±2.9 and 1.9±5.4 mm Hg, p=0.02). 12 months after SLT, the IOP level remained below the baseline IOP only in 46.9% of cases. There were no significant differences in the results of SLT at different stages of POAG, different types of glaucoma surgery, different medication regimens (p&gt;0.05), and there was no dependence on the timing after previous glaucoma surgery. Conclusion. SLT can be used after previous glaucoma surgery when IOP reduction is insufficient in patients with moderate and advanced POAG. However, the hypotensive effect of SLT in such cases is unstable, so this method of treatment should be considered only as an auxiliary one and if repeated surgery is not possible, as well as providing more frequent control of IOP in patients. Key words: glaucoma, selective laser trabeculoplasty, intraocular pressure, glaucoma surgery, ophthalmic surgery

Effect of Selective Laser Trabeculoplasty in a Mexican Population with Primary Open-angle Glaucoma

Effect of Selective Laser Trabeculoplasty in a Mexican Population with Primary Open-angle Glaucoma

What are the effects of selective laser trabeculoplasty (SLT) for people with open-angle glaucoma and ocular hypertension?

What are the effects of selective laser trabeculoplasty (SLT) for people with open-angle glaucoma and ocular hypertension?

Effectiveness of selective laser trabeculoplasty and its safety on corneal endothelium in patients with primary open angle glaucoma and ocular hypertension.

The aim of this study was to evaluate the effectiveness of selective laser trabeculoplasty (SLT) in patients with primary open-angle glaucoma (POAG) and ocular hypertension (OHT), and to assess its effects and safety on corneal endothelial cell morphology. Forty patients with POAG (15 cases, 23 eyes) and OHT (25 cases, 48 eyes) were prospectively evaluated. All cases underwent pachymetry, goniolens examination, Humphrey Visual Field Test, Optical Coherence Tomography, and Corneal Confocal Microscopy measurements. Patients whose intraocular pressure (IOP) was more than 21 mmHg in POAG and OHT, underwent SLT. SLT treatment was applied to the inferior 180° region of the trabecular meshwork. Central corneal thickness (CCT), IOP, and specular microscopy examinations were taken at the visits before and after the first day, first week, first month, third and sixth months of the SLT procedure. Retinal nerve fiber layer (RNFL) thickness measurements and visual field tests were performed before and six month post-SLT. Results of the pre-SLT and post-SLT measurements were compared and a P value of lower than 0.05 was considered statistically significant. The results of IOP measurements at first week, first month, third, and sixth month post-SLT were significantly lower than the results before and post-SLT first day. No significant difference was found between the results of initial and final measurements of CCT and specular microscopic corneal endothelial cell morphology evaluation. There was no statistically significant difference between the results of initial and final measurements for RNFL thickness and the results of the visual field tests. SLT is an effective treatment modality for reducing IOP in patients with POAG and OHT and is also a safe procedure in terms of the entirety of corneal endothelial cell morphology.

Effectiveness of selective laser trabeculoplasty in advanced open‐angle glaucoma

AbstractPurposeTo study the effectiveness and safety of selective laser trabeculoplasty (SLT) for the treatment of advanced open‐angle glaucoma.MethodsWe carried out a prospective longitudinal study, including patients with advanced open‐angle glaucoma. Selective laser trabeculoplasty has been indicated either after failure of medical treatment or in cases of poor adherence to medical treatment. Measurements were obtained at 1 week, 1 month, 3 months and 6 months. Success was defined as a reduction in intraocular pressure (IOP) of more than 20% from baseline or a reduction of at least one antiglaucoma eye drops with stable intraocular pressure. A p value less than 0.05 was considered as statistically significant.ResultsFifty‐nine eyes were included in the study. Three types of glaucoma were present in our study: primary open‐angle glaucoma was the most common type followed by exfoliative glaucoma and pigmentary glaucoma. The success rate was 76.5% for failure of medical treatment and 80% for poor adherence. The most frequent side effects were the inflammatory reaction (18.6%) and the early IOP spikes (25.4%). The predictors of its effectiveness were the initial intraocular pressure (p = 0.03) and the percentage reduction in intraocular pressure at 1 month (p = 0.002).ConclusionsSelective laser trabeculoplasty is an effective and easy‐to‐perform physical treatment of advanced open‐angle glaucoma with a satisfactory safety profile (1,2). It overcomes poor adhesion problems. Our results need to be extended to assess long‐term success.Bibliography1. Garg A, Gazzard G. Selective laser trabeculoplasty: past, present, and future. Eye (Lond). 2018 May;32(5):863–876.2. Sina Elahi, Harsha L Rao, Alina Dumitru, Kaweh Mansouri. Predictors of Success in Selective Laser Trabeculoplasty: Data From the Lausanne Laser Trabeculoplasty Registry. J Glaucoma. 2020 Jul;29(7):550–555.

Selective laser trabeculoplasty as adjunctive treatment in pseudoexfoliative glaucoma patients

Introduction/Objective. Pseudoexfoliation syndrome is characterized by abnormal production and accumulation of fibrillar, white-gray, ?dandruff-like? material in almost all ocular structures. The aim of this study was to examine effect of selective laser trabeculoplasty in pseudoexfoliation glaucoma patients. Methods. Thirty-two patients (47 eyes) with medically uncontrolled pseudoexfoliation glaucoma were enrolled. All the patients could not reach target intraocular pressure with maximal tolerated medical therapy before treatment. Selective laser trabeculoplasty was performed with about 100 non-overlapping spots. Intraocular pressure was measured one hour, seven days, four weeks, three, six, twelve, eighteen, and twenty-four months after the procedure. Results. The mean base intraocular pressure was 23.45 mmHg (SD = 3.07). Statistically significant reduction of mean intraocular pressure was observed at all follow-ups except one hour after treatment. Mean intraocular pressure after 24 months was 18.39 mmHg (SD = 1.82). Success, defined as intraocular pressure reduction from base intraocular pressure by more than 20% after 24 months, was achieved in 27 eyes (57.45%). We did not find any influence of sex and age on selective laser trabeculoplasty effects in pseudoexfoliative glaucoma patients. Baseline intraocular pressure is proved to be a reliable predictor of intraocular pressure-lowering effect, as there was a strong correlation between baseline intraocular pressure and the percentage of reduction of intraocular pressure after 24 months (r = 0.71, p &lt; 0.01). Conclusion. Selective laser trabeculoplasty is a safe and effective method for the reduction of intraocular pressure in pseudoexfoliation glaucoma patients and should be used more often in this challenging form of glaucoma. Baseline intraocular pressure seems to be a reliable predictor of success.

Comparative evaluation of hypotensive effectiveness of topical monotherapy and selective laser trabeculectomy

Comparison of the hypotensive effects of selective laser trabeculoplasty (SLT) and drug therapy in patients with newly diagnosed primary open-angle glaucoma (POAG) and ocular hypertension. Thirty patients (30 eyes) with newly diagnosed ophthalmic hypertension or POAG were observed. Patients of the 1st group (15 eyes) underwent standard SLT as a starting treatment, patients of the 2nd group (15 eyes) were prescribed monotherapy with a prostaglandin analog. Corneal compensated intraocular pressure (IOPcc) was measured for each patient using Ocular Response Analyzer («Reichert Technologies», USA). The observation period lasted 6 months. During the 6-months follow-up, tafluprost was found to effectively reduce IOP in 93.3% of cases, SLT - in 73.3% of cases. There were no statistically significant differences in hypotensive effectiveness between the two compared treatments, which amounted to 27.9-28.5% reduction from the baseline values. Selective laser trabeculectomy and topical drug therapy have shown similar hypotensive effectiveness during the 6-months follow-up when used as the initial therapy for POAG.

Effect of selective laser trabeculoplasty on primary open angle glaucoma in different stages

Effect of selective laser trabeculoplasty on primary open angle glaucoma in different stages

Comparison of Treatment Outcomes of Selective Laser Trabeculoplasty for Primary Open-Angle Glaucoma and Pseudophakic Primary Angle-Closure Glaucoma Receiving Maximal Medical Therapy.

Selective laser trabeculoplasty (SLT) is a useful treatment for intraocular pressure (IOP) control. However, there are only a few reports which compare the outcomes of SLT between primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). We compared the efficacy of SLT for patients with PACG following phacoemulsification with POAG receiving maximal medical therapy (MMT). Consecutive glaucoma patients followed up for at least 1 year after SLT were retrospectively evaluated and IOP reductions at 6 months and 12 months were analyzed. Seventy-six patients were included in the analyses. The baseline IOPs in the POAG and PACG group were 18.5 ± 3.3 mmHg and 16.9 ± 2.5 mmHg, respectively, with 2.8 ± 0.9 and 2.7 ± 0.8 types of IOP lowering medication. The average IOP at the 6-month and 12-month follow-up after SLT was significantly decreased and comparable in both the POAG and PACG groups. For those with a low baseline IOP, the effect of SLT on IOP reduction at 12 months was significantly better in the PACG than in the POAG group (p = 0.003). IOP reduction at 6 and 12 months after SLT was significantly greater in those with a high baseline IOP than those with a low baseline IOP (p < 0.0065). In summary, the one-year efficacy of SLT was equivalent in POAG and pseudophakic PACG patients receiving MMT; however, SLT was more effective in eyes with PACG than eyes with POAG when focusing on those with a lower baseline IOP.

Responsiveness to ripasudil may be a potential outcome marker for selective laser trabeculoplasty in patients with primary open-angle glaucoma

We examined responsiveness to ripasudil as a potential factor for predicting the effect of selective laser trabeculoplasty (SLT) when performed for primary open-angle glaucoma (POAG). A total of 70 eyes with no history of glaucoma surgery underwent SLT between January 2015 and June 2019. Patients were divided into two groups, with an intraocular pressure (IOP) decrease of 15% or more due to ripasudil administration before SLT defined as the effective group, while an IOP decrease of less than 15% was defined as the non-effective group. Kaplan–Meier survival analysis was performed. A Cox proportional hazards model assessed the influence of baseline factors on the success. Of the 70 eyes evaluated, treatments were effective in 22 and non-effective in 48. Postoperatively, both groups exhibited IOP reductions for up to 24 months. Success ratios at 12 and 24 months after SLT were 43.5% and 18.5% in the effective versus 24.9% and 9.3% in the non-effective group, which were significantly higher in the effective group (P = 0.03). Presence of a ripasudil effective eye (P = 0.03) was associated with treatment success. Responsiveness to ripasudil may be useful in predicting the therapeutic effect of SLT.

The Effect of Selective Laser Trabeculoplasty on Intraocular Pressure in Patients with Dexamethasone Intravitreal Implant-Induced Elevated Intraocular Pressure.

Introduction To assess the safety and efficacy of selective laser trabeculoplasty (SLT) for ocular hypertension (OHT) induced by a dexamethasone (DEX) intravitreal implant. Materials and Methods We performed a retrospective study of patients who underwent an SLT procedure for ocular hypertension induced by injection of a DEX intravitreal implant. Patients had, at least, one injection of the DEX-implant for symptomatic macular edema. SLT was delivered to 360° of the trabecular meshwork in two sessions. The primary outcome was a decrease in IOP, evaluated at one, three, and six months after the SLT procedure. Results Twenty-six eyes of 22 patients were included. The mean intraocular pressure (IOP) measured after DEX-implant injection was 25.4 ± 5.4 mmHg, and the mean increase in IOP was 35.8 ± 14.6%. The mean follow-up after SLT was 18.3 ± 7.7 months. After SLT, the mean IOP dropped by 30.9% at one month (16.9 ± 4.5 mmHg, p=0.01), 33.6% at three months (16.0 ± 2.7 mmHg, p < 0.01), and 34.9% at six months (15.6 ± 2.1 mmHg, p < 0.01). Each patient had a minimum follow-up of 6 months after SLT. Eight eyes (31%) received a second DEX-implant injection after the SLT procedure without experiencing an increase in the IOP above 21 mmHg or >20%. No glaucoma surgery was required during the follow-up. The mean number of medications (1.65 ± 1.36) was significantly reduced at one (1.19 ± 1.20, p=0.04), three (0.96 ± 1.03, p < 0.01), and six months (0.77 ± 0.95, p < 0.01) after SLT. Conclusion SLT is an effective and safe procedure to control OHT following DEX-implant intravitreal injection.

Evaluation of the effectiveness of selective laser trabeculoplasty (SLT) in patients with open angle glaucoma

Glaucoma is second leading cause of blindness in world. Various treatment modalities are available for glaucoma management. Thus, the question arises whether SLT can be interchangeably used in place of medical drugs or not.To examine the effect of selective laser trabeculoplasty (SLT) as a replacement therapy for medically controlled primary open-angle glaucoma (POAG) patients.A longitudinal studySLT was performed in 30 eyes of 15 patients with medically controlled primary open-angle glaucoma (POAG) cases from June 2018 to October 2019 and with no previous history of glaucoma surgery. Data were recorded 1 hr, 1day, 1 week, 1, 3 and 6 months after SLT. The primary outcome was number of medications at 6 months while maintaining a predetermined target intraocular pressure (IOP).Selective laser trabeculoplasty (SLT) reduced number of medications from a mean of 1.6 at baseline to 0.17 after 6 months. Meanwhile, SLT achieved more than 20% IOP lowering in 100% of eyes after 6 months. Eighty seven percent of our eyes no longer needed any medication after SLT at 6 months.Selective laser trabeculoplasty was able to completely replace medical therapy in 87% of eyes after 6 months. Medically managed POAG patients who underwent SLT, maintained good IOP control with less medications, better compliance, reduced side effects and financial burden.

The outcomes of selective laser trabeculoplasty at six months

Purpose: To study the intraocular pressure (IOP)-lowering effects of selective laser trabeculoplasty (SLT) at six months and to determine factors that can predict the success of SLT.&#x0D; Study design: Prospective cohort study with convenience sampling.&#x0D; Material and methods: The patients were seen at the Glaucoma Clinic, Selayang Hospital from October 2017 to September 2018. Patients with primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), and ocular hypertension (OHT) of mild to moderate severity that needed further IOP reduction were recruited. Baseline characteristics were documented followed by water drinking test (WDT) and SLT. Follow-up was scheduled at one week, six weeks, three months, and six months. WDT was repeated at six months.&#x0D; Results: Eighteen eyes of 18 patients were recruited. IOP at baseline, 1 week, 6 weeks, 3 months, and 6 months was 19.3 ± 3.7,16.7 ± 3.8,16.5 ± 2.7,16.6 ± 3.2 and 15.3 ± 3.8 mmHg, respectively (P &lt; 0.05). The reduction of baseline IOP, peak IOP, and IOP fluctuation were 20.7%, 26.7%, and 31.4%, respectively (P &lt; 0.05). The cumulative success at six months was 44%. The significant success predictors were mean deviation on Humphrey visual field and IOP one week post-SLT.&#x0D; Conclusions: SLT can be used to treat mild to moderate POAG, NTG, and OHT patients, either as first-line treatment or as an adjunct to medical therapy.

Effectiveness of Selective Laser Trabeculoplasty as Initial or Adjunctive Treatment for Primary Open-Angle Glaucoma.

Objectives:The aim of this study was to evaluate the effectiveness of selective laser trabeculoplasty (SLT) at lowering intraocular pressure (IOP) as initial or adjunctive treatment in patients with primary open-angle glaucoma (POAG).Methods:This was a prospective, comparative study. A total of 162 eyes of 81 patients with bilateral POAG were evaluated. The patients were categorized into 2 groups. SLT was performed as an adjunctive treatment in 42 POAG patients (Group 1, 84 eyes) and as initial treatment in 39 POAG patients (Group 2, 78 eyes).Results:The mean baseline IOP and post-SLT IOP for the entire study group was 23.3±4.8 mm Hg and 14.6±2.7 mm Hg, respectively. The mean percentage reduction of IOP post-SLT at the final visit was 34.5% in Group 1 and 40.5% in Group 2. The number of medications used in the Group 1 before SLT was 2.11±0.88 (range: 1-4), while after SLT, medication use decreased to 0.9 ±0.15 (range: 0-3). The mean length of follow-up was 49.85±8.2 weeks (range: 24-78 weeks).Conclusion:SLT can be used effectively as a primary or an adjunctive therapy for the treatment of POAG. It was also effective at reducing the quantity of medications used. The reduction in IOP was similar in the primary and adjunctive group for up to 1 year of follow-up.

Biomechanical properties of the cornea as predictors of the effectiveness of selective laser trabeculoplasty

To study the changes in central corneal thickness (CCT) and corneal hysteresis (CH) after selective laser trabeculoplasty (SLT) in primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) after laser peripheral iridotomy (LPI) and to determine their effect on the prognosis of the surgery. The prospective study involved 68 eyes with initial PACG after LPI and 74 eyes with initial POAG observed for 6 months. Corneal-compensated IOP (IOPcc), corneal resistance factor (CRF), CH and CCT were studied as the predictors of SLT, which was considered successful when IOPcc decreased by 20% or more from the baseline without additional hypotensive therapy and/or repeated SLT. In both forms of glaucoma, CCT increased within the first hour after SLT: 567±24.08 µm (p=0.001) in POAG, and 572±21.41 µm (p=0.000) - persisting for over a month - in PACG. CCT correlated with laser energy at all stages of the examination both in POAG and PACG patients. The following predictors of SLT failure were determined: CH (p=0.000 in PACG and p=0.001 in POAG), as well as initial IOP (p=0.010 in PACG and p=0.016 in POAG) and CRF (p=0.003 in PACG and p=0.005 in POAG) and CCT (p=0.023 in PACG and p=0.026 in POAG). The value of anterior chamber angle (ACA) was a predictor only for PACG (p=0.011). SLT leads to an increase in CCT, which lasts longer in PACG after LPI than in POAG and correlates with the level of laser energy. Lower CH and initially higher IOP are the common predictors of SLT failure in the long term for both forms of glaucoma. Smaller ACA have a negative prognostic sign in POAG.

Effectiveness of selective laser trabeculoplasty in glaucoma patients: a 6 years follow up study

AbstractThe use of laser trabeculoplasty (SLT) to lower intraocular pressure (IOP) has provided an alternative strategy to treat open angle glaucoma (OAG) or ocular hypertension (OHT). SLT lowers IOP by enhancing aqueous humor outflow through the trabecular meshwork. It induces less coagulative damage than argon laser trabeculoplasty. The effect of SLT diminishes over time and some patients may need more treatment or surgery.PurposeTo evaluate long‐term effectiveness of SLT in OAG/OHT.MethodsRetrospective cohort study. All patients with OAG/OHT treated in 2012 with 180º SLT were included. Patients with &lt;1 year of follow up were excluded. Following SLT, patients were examined at 6, 12, 24, 36, 48, 60 and 72 months. In each visit IOP was measured, and fundus and anterior segment were examined. Structural images and visual fields were performed to asses glaucoma progression.ResultsSeventy‐eight eyes of 49 patients were included. Mean age was 65.2 ± 12.2 years old. Forty two eyes had OAG, 6 pseudo‐exfoliation glaucoma, two pigmentary glaucoma, two aphakic glaucoma and 26 had OHT. The mean follow‐up was 5.2 ± 1.4 years. Mean previous IOP was 21.2 ± 3.7 mmHg. After treatment, and excluding patients who required surgery, IOP had significantly decreased to 17.1 ± 3.2 mmHg at one year (n = 73; p &lt; 0.001) and to 17.4 ± 3.5 mmHg (p &lt; 0.001) at 6 years of follow‐up (n = 41). The number of drugs used was 2 ± 1.1 before treatment and 1.9 ± 1.2 (n = 41; p = 0.55) after 6 years. A total of 35 eyes (27.3%) needed more than one SLT session to achieve the desired IOP and 18 eyes (23.1%) needed glaucoma surgery in a mean time of 2 years after the first SLT. None of the patients had major complications related to SLT treatment.ConclusionAlthough the effect of SLT decreases with time, our study shows that it can be an effective technique to significantly lower IOP after 6 years of follow up.