scholarly journals Efficacy and safety of selective laser trabeculoplasty and pattern scanning laser trabeculoplasty: a randomised clinical trial

2020 ◽  
pp. bjophthalmol-2020-316178
Author(s):  
Mandy Oi Man Wong ◽  
Isabel SW Lai ◽  
Poemen Puiman Chan ◽  
Noel CY Chan ◽  
Alison YY Chan ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Open Angle Glaucoma ◽  
Treatment Success ◽  
Randomised Clinical Trial ◽  
Retinal Nerve Fibre Layer ◽  
Scanning Laser ◽  
Mean Deviation ◽  
Selective Laser Trabeculoplasty ◽  
Laser Trabeculoplasty

AimsTo compare the intraocular pressure (IOP) lowering effect and safety profile between pattern scanning laser trabeculoplasty (PSLT) and selective laser trabeculoplasty (SLT) in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT) over a 12-month follow-up.Methods132 patients with POAG or OHT were consecutively enrolled and randomised (1:1) to receive PSLT (n=65) or SLT (n=67) in a single centre. IOP was measured before and then on 1 day, 1 week, 1, 3, 6, 9 and 12 months after PSLT/SLT. The primary outcome measure was the proportion of patients with ≥20% IOP reduction at 12 months without IOP-lowering medications (complete success).ResultsThe mean baseline IOP was 21.2±4.1 mm Hg for eyes randomised to PSLT and 21.3±4.7 mm Hg for eyes randomised to SLT (p=0.898). At 12 months, the IOP was 18.3±3.1 and 17.8±3.4 mm Hg, respectively (p=0.402). IOP measurements were comparable between the groups over 12 months (overall mean difference 0.4 mm Hg, 95% CI: −0.5 to 1.3 mm Hg). 15.4% of PSLT-treated and 25.4% of SLT-treated patients achieved treatment success (difference: 10.0%, 95% CI: −3.6 to 23.6) (p=0.155), respectively. A higher baseline IOP and a greater percentage of IOP reduction at day 1 were associated with a greater percentage of IOP reduction at 12 months (p<0.001). There were no significant differences in visual field mean deviation, average retinal nerve fibre layer thickness, corneal endothelial cell count and visual acuity between the treatment groups at the baseline and 12-month follow-up (p≥0.062).ConclusionsPSLT was not superior to SLT in terms of safety and IOP-lowering efficacy in patients with POAG or OHT.Trial registration numberThe clinical trial was registered in the Centre for Research and Biostatistics Clinical Trials Registry, the Chinese University of Hong Kong (Identifier CUHK_CCT00407). The full trial protocol can be accessed from the authors on request.

scholarly journals The outcomes of selective laser trabeculoplasty at six months

2020 ◽  
Vol 2 (2) ◽  
pp. 112-124
Author(s):  
Swee Sew Teh ◽  
Poh Yan Ong
Keyword(s):  
Open Angle Glaucoma ◽  
Normal Tension Glaucoma ◽  
Mean Deviation ◽  
Selective Laser Trabeculoplasty ◽  
Success Predictors ◽  
Laser Trabeculoplasty ◽  
Drinking Test ◽  
Baseline Characteristics ◽  
Water Drinking Test

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. Study design: Prospective cohort study with convenience sampling. 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. 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 < 0.05). The reduction of baseline IOP, peak IOP, and IOP fluctuation were 20.7%, 26.7%, and 31.4%, respectively (P < 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. 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.

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.

scholarly journals Effect of primary selective laser trabeculoplasty on tonographic outflow facility: a randomised clinical trial

2010 ◽  
Vol 94 (11) ◽  
pp. 1443-1447 ◽  
Author(s):  
S. Goyal ◽  
L. Beltran-Agullo ◽  
S. Rashid ◽  
S. P. Shah ◽  
R. Nath ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomised Clinical Trial ◽  
Selective Laser Trabeculoplasty ◽  
Outflow Facility ◽  
Laser Trabeculoplasty

Selective laser trabeculoplasty in enhancing glaucoma care

2019 ◽  
Vol 25 (11) ◽  
pp. 324-330
Author(s):  
Sohaib R Rufai ◽  
Mohammed R Kamal ◽  
Riddhi D Thaker ◽  
Subhanjan Mukherji
Keyword(s):  
Ocular Hypertension ◽  
Open Angle Glaucoma ◽  
Eye Drops ◽  
Line Treatment ◽  
Selective Laser Trabeculoplasty ◽  
First Line ◽  
Topical Medication ◽  
Laser Trabeculoplasty ◽  
First Line Treatment

Background/Aim There is increasing evidence for using selective laser trabeculoplasty as a first line treatment for chronic open angle glaucoma. The current first-line treatment is pharmacological therapy using eye drops. This study aims to assess the outcomes of selective laser trabeculoplasty in patients with glaucoma and ocular hypertension at a district general hospital and consider its role in reducing cost and treatment burden when treating patients with these conditions. Methods A single centre, retrospective case-note audit involving 58 eyes from 31 patients with a minimum follow-up of 4 months. Results Post selective laser trabeculoplasty, 62% had intraocular pressure <20 mmHg on latest follow up (36/58 eyes). Post selective laser trabeculoplasty, 10 patients (32%) were prescribed one fewer topical medication, while 20 patients (65%) were prescribed the same number of topical medications. Only 1 patient (3%) was prescribed one additional topical medication. Conclusion Selective laser trabeculoplasty is a safe and effective option for managing glaucoma and ocular hypertension. Selective laser trabeculoplasty may represent a cost-effective solution for healthcare providers as compared to pharmacological treatment.

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