Selective laser trabeculoplasty after ineffectiveness of glaucoma eye drops for patients with primary open-angle glaucoma

Introduction: Selective laser trabeculoplasty (SLT) has been demonstrated to lower intraocular pressure (IOP) and reduce the number of topical medications used in patients with primary open-angle glaucoma (POAG). Purpose: The purpose of our study was to investigate the sustainability and efficacy of SLT in treating POAG at one year following laser. To our knowledge, this is one of the first studies to be published based on local data in Malaysia. Study design: This was a retrospective study conducted in a specialist eye clinic, Hospital Kuala Lumpur, from July 2017 until January 2019. Data was collected from the medical notes of the patients. Materials and methods: The study recruited cases of POAG patients who were using topical antiglaucoma medications. Inclusion criteria were patients with unilateral or bilateral POAG aged 50 years and above. Exclusion criteria were secondary open-angle glaucoma and all forms of angle-closure glaucoma. Patients who had undergone trabeculectomy or glaucoma drainage devices were excluded in our study. A single session of 360° SLT using a Q-switched Nd:YAG laser with an initial energy of 0.8 mJ was performed. IOP and number of antiglaucoma medications were recorded at prestudy, 1 week, 1 month, 3 months, 6 months, and 12 months. Results: In 17 eyes, mean prestudy IOP was 19.3 ± 3.3 mmHg while on 2.18 ± 0.7 eye drops. At 12 months after SLT, mean IOP was 13.3 ± 3.5 mmHg while on 1.88 ± 0.9 IOP-lowering eye drops. This represented a 31% reduction of IOP compared to prestudy levels. However, the reduction of number of medications was not statistically significant. Conclusion: A single session of 360° SLT treatment for POAG patients is able to lower IOP by 31% at one year following laser. SLT is a safe and effective procedure for reducing IOP. It may be used as adjuvant therapy, especially in noncompliant patients; patients who have difficulty applying topical eye drops or who are intolerant to topical medication.

Download Full-text

Intraocular Pressure-Lowering Potential of Subthreshold Selective Laser Trabeculoplasty in Patients with Primary Open-Angle Glaucoma

Journal of Ophthalmology ◽

10.1155/2016/2153723 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Hong Yang Zhang ◽

Yong Jie Qin ◽

Yang Fan Yang ◽

Jian Gang Xu ◽

Min Bin Yu

Keyword(s):

Intraocular Pressure ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Initial Energy ◽

The Other ◽

Open Angle ◽

Selective Laser Trabeculoplasty ◽

Laser Trabeculoplasty ◽

Pressure Lowering ◽

Laser Flare

Purpose.To compare the efficacy of subthreshold and conventional selective laser trabeculoplasty (SLT) in lowering intraocular pressure (IOP) in the patients with primary open-angle glaucoma (POAG).Methods.Fifty-two eyes from fifty-two POAG patients were randomized into two groups, one group treated with subthreshold SLT using two-thirds of the conventional energy and the other one treated with the conventional energy. IOP was measured with the Goldmann tonometer and the anterior chamber inflammation was determined using laser flare meter.Results.The initial energy dosage used in subthreshold SLT group was significantly lower than the amount of the energy used in conventional SLT group (0.4±0.1 mJ versus0.6±0.1 mJ,P=0.030). The total energy dosage was also significantly lower in subthreshold SLT group compared to the other group (37.6±3.3 mJ versus51.8±5.7 mJ,P=0.036). However, the level of inflammation in aqueous humor, amount of reduction in IOP, and the success rate in controlling IOP was the same in both groups.Conclusion.The efficacy of subthreshold SLT group in reducing IOP in POAG patients is comparable to the efficacy of conventional SLT group.

Download Full-text