Comparative analysis of one year outcomes of selective laser trabeculoplasty versus argon laser trabeculoplasty in Primary Open Angle Glaucoma patients in Nigeria

Purpose: To compare the efficacy of the microwave pulse diode laser and argon laser trabeculoplasty in primary open angle glaucoma. Study Design: Quasi experimental study. Place and Duration of Study: Shaheed Mohtarma Benazir Bhutto Medical College Lyari and Sindh Government Lyari General Hospital, Karachi, from October, 2017 to March, 2018. Material and Methods: One hundred and sixty patients, between 42 to 61 years with visual acuity of perception of light to 6/36 were enrolled. Patients diagnosed with POAG were included and patients with intraocular pressure of more than 40 mm Hg, previous glaucoma surgery or laser treatment and narrow angle on gonioscopy were excluded. Ophthalmic examination included visual acuity, slit lamp examination, fundus examination and visual field status using Humphrey perimeter. Patients were divided into two groups. Group A received microwave pulse diode laser (810) and Group B received argon laser trabeculoplasty. Average follow up period was 6 months. Success was assessed objectively by measuring intra ocular pressure and subjectively by visual acuity. Results: The average time-period for each procedure was 15 ± 5 minutes. In Group A, mean IOP at first week, first month, third month and sixth month was 20.79, 16.34, 16.21and 16.09 mm Hg respectively. While in Group B, IOP at first week, first, third and sixth month was 16.52, 15.76, 13.62, and 12.54 mm Hg at (P < 0.001 in both groups). Conclusion: Both microwave pulse diode laser and argon laser trabeculoplasty are effective in lowering intra ocular pressures in patients with primary open angle glaucoma.

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Is Argon Laser Trabeculoplasty Equivalent to Topical Medication as an Initial Treatment for Primary Open-Angle Glaucoma?

50 Studies Every Ophthalmologist Should Know ◽

10.1093/med/9780190050726.003.0011 ◽

2020 ◽

pp. 61-66

Author(s):

Alan D. Penman ◽

Kimberly W. Crowder ◽

William M. Watkins

Keyword(s):

Initial Treatment ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Argon Laser ◽

Controlled Clinical Trial ◽

Open Angle ◽

Safe Alternative ◽

Topical Medication ◽

Argon Laser Trabeculoplasty ◽

Laser Trabeculoplasty

The Glaucoma Laser Trial (GLT) was a randomized, single-blind, controlled clinical trial comparing the efficacy and safety of argon laser trabeculoplasty (ALT) to treatment with topical medication for controlling intraocular pressure (IOP) in patients with newly diagnosed, previously untreated, primary open-angle glaucoma (POAG). The study showed that initial treatment of POAG with ALT is an efficacious and safe alternative to medication therapy, particularly in patients where medical therapy is contraindicated or poor compliance is suspected. The initial use of ALT in the short term has the benefit of reducing the nuisance, inconvenience, and systemic side effects of the topical glaucoma medication alternatives.

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

Malaysian Journal of Ophthalmology ◽

10.35119/myjo.v1i3.54 ◽

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.

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Selective laser trabeculoplasty in patients with pseudoexfoliative glaucoma vs primary open angle glaucoma: a one-year comparative study

International Journal of Ophthalmology ◽

10.18240/ijo.2016.03.14 ◽

2016 ◽

Keyword(s):

Comparative Study ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Open Angle ◽

Selective Laser Trabeculoplasty ◽

Pseudoexfoliative Glaucoma ◽

Laser Trabeculoplasty ◽

One Year

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Efficacy and Safety of Argon Laser Trabeculoplasty in Lowering Intraocular Pressure as Adjunctive Treatment to Primary Open Angle Glaucoma

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v35i1.856 ◽

2019 ◽

Vol 35 (1) ◽

Author(s):

Uzma Fasih, Erum Shahid Arshad Sheikh

Keyword(s):

Intraocular Pressure ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Argon Laser ◽

Adjunctive Treatment ◽

P Value ◽

Open Angle ◽

Argon Laser Trabeculoplasty ◽

Laser Trabeculoplasty

Purpose: To assess efficacy and safety of argon laser trabeculoplasty (ALT) to lower intra ocular pressure (IOP) as adjunctive treatment in primary open angle glaucoma (POAG) patients. Study Design: Descriptive Cross Sectional. Place and Duration of Study: Ophthalmology Department, Abbassi Shaheed Hospital from May 2016 to August, 2017. Materials and Methods: Primary open glaucoma patients were selected from eye OPD. Patients with Inflammatory, angle closure, traumatic glaucoma were excluded. Pre laser and Post laser IOP was measured at 1st week then at 1, 3 and 6 months. Data was collected and analyzed on SPSS version 20. There were 114 patients Results: There were 69 (61%) male patients. Mean age of patients was 60.53 ± 10.71 years. Mean pre laser Intraocular pressure was 23.98 ± 10.01 mm Hg. Mean post laser IOP at one month was 15.6 ± 3.25 and at 6 months was 14.8 ± 3.28 mm Hg. Overall mean reduction of IOP was 9.18 mm Hg from baseline, with p value less than < 0.005. Pre laser 3 medications were used by 20 (18%) and 2 medications by 49 (43%). At 6 months follow-up 4 (3.5%) patients were on 3 medications and 31 (37%) were on 2 medications. It has a p value < 0.005. Drug free patients at 6 months follow-up were 37 (33%). Mild iritis was seen in 7 (6.14%) patients. Conclusion: Argon Laser Trabeculoplasty is effective and safe method to control IOP in POAG when used as an adjunct to medical therapy. It also decreases number of drugs used by patients. Key Words: Argon laser trabeculoplasty, intraocular pressure, primary open angle glaucoma.

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