scholarly journals Efficacy of selective laser trabeculoplasty in primary open-angle glaucoma: HKL experience, one-year results

2019 ◽  
Vol 1 (3) ◽  
pp. 170-180
Author(s):  
Lim Chuan Chun ◽  
Jelinar Mohamed Noor ◽  
Norlina Mohd Ramli ◽  
Ch'ng Tun Wang ◽  
Gan Eng Hui
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Angle Closure ◽  
Eye Drops ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Single Session ◽  
Local Data ◽  
Laser Trabeculoplasty ◽  
One Year

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.

scholarly journals Hypotensive effect of selective laser trabeculoplasty in patients with medically uncontrolled primary open-angle glaucoma

2014 ◽  
Vol 142 (9-10) ◽  
pp. 524-528 ◽  
Author(s):  
Marko Kontic ◽  
Dragana Ristic ◽  
Miroslav Vukosavljevic
Keyword(s):  
Surgical Treatment ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Congenital Glaucoma ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Initial Value ◽  
Laser Trabeculoplasty ◽  
The Mean ◽  
One Year

Introduction. Glaucoma is a chronic, progressive disease of the optic nerve which if left untreated can lead to blindness at end stages. A decrease of intraocular pressure (IOP) has proven to slow down the progression of the disease. IOP decrease can be achieved by medical, laser and surgical treatment. Objective. The aim of this study was to evaluate the response of patients with medically uncontrolled primary open angle glaucoma to selective laser trabeculoplasty (SLT). Methods. The study involved baseline characteristics recorded for each of 35 patients (48 eyes) in whom, despite being under full medication we could not achieve a satisfactory IOP. Patients, who had pressure above 25 mmHg under the maximal medication therapy, were not included into the study and were referred for surgical treatment. IOP was measured on admission, 1 hour, 7 days, 1, 3, 6 and 12 months after SLT. We considered satisfactory surgical result if IOP was decreased more than 20% of the initial value. Also, we investigated the influence of baseline IOP on SLT outcome after 12 months. Patient inclusion criteria were inability to reach target IOP with maximal medical therapy. Exclusion criteria were congenital glaucoma, any type of angle closure glaucoma, advanced-stage glaucoma, eyes with previous laser or surgical glaucoma applications and patients with baseline IOP >25 while fully medicated. Patients who could not be followed for at least 12 months were also excluded. Results. The mean age of our patients was 73?12 years. The mean baseline IOP was 20.48 mmHg (SD=1.91), and the mean change in IOP from baseline of the treated eye after one year was 4.47 mmHg (SD=2.12). In eyes with a higher baseline IOP the reduction of pressure at the end of the study was significantly higher. Satisfactory effect of IOP reduction after one year was achieved in 64.58% of eyes. The IOP reduction did not show to be dependent as regarding age and gender. Conclusion. SLT effectively lowers IOP in patients with primary open-angle glaucoma, and the intervention is not followed by significant complications. Our results confirm that the IOP reduction is more significant if the initial value is higher. Our first reliable results of IOP reduction were confirmed one month after the procedure so that the procedure should not be repeated before one month has elapsed. The study is limited by a small number of eyes, which is insufficient to make a complete case analysis.

scholarly journals Selective Laser Trabeculoplasty Protects Glaucoma Progression in the Initial Primary Open-Angle Glaucoma and Angle-Closure Glaucoma after Laser Peripheral Iridotomy in the Long Term

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Natalia Ivanovna Kurysheva ◽  
Lyudmila Vyacheslavovna Lepeshkina
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Angle Closure ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Laser Peripheral Iridotomy ◽  
Laser Trabeculoplasty ◽  
Rate Of Progression ◽  
Peripheral Iridotomy

Purpose. To compare the ability of SLT in preventing glaucoma progression in the initial primary angle-closure glaucoma (PACG) after laser peripheral iridotomy and primary open-angle glaucoma (POAG) in the long term. Methods. 60 patients with the initial stage of PACG after laser peripheral iridotomy and 64 initial POAG patients were recruited in a prospective study. Complete success of selective laser trabeculoplasty (SLT) was defined as a 20% intraocular pressure (IOP) reduction with topical hypotensive medications without any hypotensive intervention. Pre-SLT rate of progression and post-SLT rate of progression (ROP) was detected in the both groups by means of the trend and the event analysis of perimetry, the Guided Progression Analysis, and the optical coherence tomography- (OCT-) based negative trend for either the thickness of the peripapillary retinal nerve fiber layer (RNFL) or ganglion cell complex (GCC). Results. IOP decreased significantly after SLT in both the groups. 30% in PACG and 19% in POAG had the progression according to perimetry and 49% in PACG and 40% in POAG had the progression, respectively, according to OCT. After SLT, ROP was reduced from −0.14 ± 0.39 dB/year to −0.08 ± 0.48 dB/year, p=0.034, in PACG and from −0.09 ± 0.36 dB/year to −0.04 ± 0.43 dB/year, p=0.021, in POAG. According to RNFL trend analysis, ROP was reduced from −1.86 ± 2.9 μm/year to −1.38 ± 2.2 μm/year, p=0.039, and from −1.24 ± 2.23 μm/year to −0.76 ± 1.73 μm/year, p=0.037, in PACG and POAG, and according to GCC, ROP was reduced from −1.88 ± 2.9 μm/year to −1.34 ± 2.0 μm/year, p=0.040, and from −1.35 ± 2.16 μm/year to −0.91 ± 1.86 μm/year, p=0.040, in PACG and POAG, respectively. ROP was significantly faster in PACD than in POAG between 2 and 6 years after SLT: −0.15 ± 0.46 dB/year and 0.02 ± 0.38 dB/year (p=0.042). However, it did not differ significantly according to OCT. Conclusion. SLT is an effective treatment for initial PACG after LPI and POAG that can prevent functional and structural deterioration in the long term.

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

2021 ◽  
Vol 10 (13) ◽  
pp. 2853
Author(s):  
Pei-Yao Chang ◽  
Jiun-Yi Wang ◽  
Jia-Kang Wang ◽  
Tzu-Lun Huang ◽  
Yung-Ray Hsu
Keyword(s):  
Medical Therapy ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Angle Closure ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Primary Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Laser Trabeculoplasty ◽  
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.

Hydrus microstent compared to selective laser trabeculoplasty in primary open angle glaucoma: one year results

2016 ◽  
Vol 45 (2) ◽  
pp. 120-127 ◽  
Author(s):  
Antonio M Fea ◽  
Iqbal Ike K Ahmed ◽  
Carlo Lavia ◽  
Pietro Mittica ◽  
Giulia Consolandi ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Selective Laser Trabeculoplasty ◽  
Laser Trabeculoplasty ◽  
One Year

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

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
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.

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