scholarly journals Predictors of selective laser trabeculoplasty success in open angle glaucoma or ocular hypertension: does baseline tonography have a predictive role?

2020 ◽  
Vol 104 (10) ◽  
pp. 1390-1393 ◽  
Author(s):  
Pouya Alaghband ◽  
Elizabeth Angela Galvis ◽  
Arij Daas ◽  
Anindyt Nagar ◽  
Laura Beltran-Agulló ◽  
...  
Keyword(s):  
Ocular Hypertension ◽  
Open Angle Glaucoma ◽  
Multivariate Regression Analysis ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Eligibility Criteria ◽  
Laser Trabeculoplasty ◽  
Treatment Naïve ◽  
Predictive Role

BackgroundThe determinants of success of selective laser trabeculoplasty (SLT) in treatment-naïve patients with open angle glaucoma (OAG) and ocular hypertension (OHT) have not been understood fully. Therefore, we have conducted this study to explore the predictors of success.MethodsThis is a retrospective review of a pre-existing database of patients who had received primary SLT at St Thomas’ Hospital, London, UK. Patients with OAG and OHT who had received primary 360° SLT treatment and had reliable baseline tonographic outflow facility (TOF) with minimum of 1 year of follow-up were included. Univariate and multivariate analyses were performed to find the determinants of success.ResultsOne hundred and seventy-four patients between August 2006 and February 2010 had received primary 360° SLT treatment and had baseline TOF measurement. Of these, 72 subjects fulfilled the eligibility criteria. In multivariate regression analysis, the only variable associated with success was baseline intraocular pressure (IOP) (R2=0.32, beta=−0.51, p<0.001, 95% CI −2.02 to −0.74).ConclusionTo our knowledge, this is the only study investigating the pretreatment TOF (measured with electronic Shiøtz tonography) and IOP as determinants of success 12 month’s post-360° SLT in treatment-naïve patients with OAG and OHT. This study demonstrated that pretreatment IOP (and not TOF) is the only determinant of success after primary SLT therapy.

scholarly journals Selective Laser Trabeculoplasty in the Treatment of Ocular Hypertension and Open-Angle Glaucoma: Clinical Review

2021 ◽  
Vol 10 (15) ◽  
pp. 3307
Author(s):  
Aleksandra Zgryźniak ◽  
Joanna Przeździecka-Dołyk ◽  
Marek Szaliński ◽  
Anna Turno-Kręcicka
Keyword(s):  
Ocular Hypertension ◽  
Laser Energy ◽  
Open Angle Glaucoma ◽  
Biological Effects ◽  
Primary Treatment ◽  
Treatment Modalities ◽  
Complication Rates ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Laser Trabeculoplasty

Selective laser trabeculoplasty (SLT) is a glaucoma treatment that reduces intraocular pressure (IOP). Its mechanism is based on the biological effects of the selective application of laser energy to pigmented trabecular meshwork (TM) cells, resulting in increased outflow facility. Herein, we review current publications on SLT and summarize its efficacy and safety for different indications in open-angle glaucoma (OAG) and ocular hypertension (OHT) treatment. SLT effectively reduces IOP when used as a primary treatment. In patients whose IOP is medically controlled, SLT helps to reduce medication use, and when maximally tolerated topical therapy is ineffective, SLT facilitates the realization of the target IOP. SLT is a repeatable procedure for which the vast majority of complications are mild and self-limiting. With effective IOP reduction, low complication rates and the potential to repeat the procedure, SLT offers the possibility of delaying the introduction of medical therapy and other more invasive treatment modalities while simultaneously avoiding the accompanying complications. With this knowledge, we suggest that SLT be considered as an essential primary treatment option in OAG and OHT, switching to other treatment modalities only when laser procedures are insufficient for achieving the required target IOP.

scholarly journals Primary Selective Laser Trabeculoplasty for Open-Angle Glaucoma and Ocular Hypertension

Ophthalmology ◽  
2019 ◽  
Vol 126 (9) ◽  
pp. 1238-1248 ◽  
Author(s):  
Anurag Garg ◽  
Victoria Vickerstaff ◽  
Neil Nathwani ◽  
David Garway-Heath ◽  
Evgenia Konstantakopoulou ◽  
...  
Keyword(s):  
Ocular Hypertension ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Laser Trabeculoplasty

Long-term Follow-up of Diode Laser Trabeculoplasty for Primary Open-angle Glaucoma and Ocular Hypertension

Ophthalmology ◽  
1993 ◽  
Vol 100 (11) ◽  
pp. 1614-1618 ◽  
Author(s):  
Anthony P. Moriarty ◽  
J. Dominic A. McHugh ◽  
Timothy J. ffytche ◽  
John Marshall ◽  
A.M. Peter Hamilton
Keyword(s):  
Ocular Hypertension ◽  
Diode Laser ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Laser Trabeculoplasty ◽  
Long Term Follow Up

scholarly journals Complex use of energetic surgery in treatment of patients with primary open-angle glaucoma and cataract on the background of pseudoexfoliative syndrome

2021 ◽  
Vol 14 (3) ◽  
pp. 25-34
Author(s):  
Benta G. Dzhashi ◽  
Sergei V. Balalin
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Hypotensive Effect ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Visual Functions ◽  
Incipient Stage ◽  
Laser Trabeculoplasty

BACKGROUND: Glaucoma remains one of the current problems of modern ophthalmology. The combination of glaucoma and cataract is observed in 1738.6% of cases, and glaucoma with pseudoexfoliative syndrome in 2050% of primary open-angle glaucoma cases. AIM: The aim of this work is to develop an effective and safe technology of complex energetic surgical treatment of the incipient primary open-angle glaucoma stage and cataract on the background of pseudoexfoliation syndrome on the basis of modified laser, hydrodynamic and ultrasound methods use. MATERIALS AND METHODS: 187 patients (187 eyes) with the incipient stage of primary open-angle glaucoma, cataract and pseudoexfoliation syndrome were examined. In the main group (111 eyes), selective laser trabeculoplasty followed by femtosecond laser-assisted cataract surgery with hydrodynamic trabeculocleaning was performed. Patients in the control group (76 eyes), after selective laser trabeculoplasty, underwent phacoemulsification according to the standard technique. RESULTS: The developed technology allowed to reach the hypotensive effect in 35.2% (t=23.0; р 0.001) of baseline intraocular pressure values, of individual intraocular pressure level without adding IOP-lowering medications in 27% of cases, stabilization of visual functions and morphometric indices of the optic disc during 2 years of follow-up in 97.3% of cases unlike the selective laser trabeculoplasty with subsequent phacoemulsification (21.2, 5.3 and 81.6% respectively). The patients of the main group had significantly lower energy expenditure during the stage of phacoemulsification, a lower percentage of postoperative inflammatory reaction was noted, and a persistent hypotensive effect with stabilization of visual functions was achieved based on the results of a two-year follow-up. CONCLUSIONS: Femtosecond laser-assisted phacoemulsification, performed as part of complex treatment in patients with cataract and incipient stage of primary open-angle glaucoma, is a sparing method that minimizes surgical trauma and achieves a persistent hypotensive effect, reduces intraocular pressure to an individual level and stabilizes visual functions in 97.3% of cases.

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