Title : Selective laser trabeculoplasty as initial and adjunctive treatment for open angle glaucoma
Abstract:
Background:
Laser trabeculoplasty (LTP) has been used as initial, adjunct, or replacement therapy to lower intraocular pressure (IOP) in patients with open angle glaucoma for 35 years ago. The original procedure was described using argon laser. However, argon laser trabeculoplasty (ALT) was found to produce significant tissue disruption and coagulative damage to the trabecular meshwork. Furthermore, a membrane formed by the migrating endothelial cells was noted on the meshwork between the laser spots was hypothesized to be responsible for the late IOP rise after ALT.
Purpose:
To evaluate the efficacy of selective laser trabeculoplasty when used as an initial or adjunctive treatment in primary open angle glaucoma (POAG).
Methods:
The study included 74 eyes in 37 patients with POAG. They were grouped into 3 groups. Group I newly diagnosed eyes with POAG (Primary treatment group). Group II patients diagnosed with POAG currently on medical treatment, either intolerant of medical treatment or not well controlled to the target level (secondary treatment group). Group III control subjects: Patients with POAG with controlled IOP on prostaglandins analogues eye drops. SLT with360o treatment was done in Group I and Group II.
Results:
In group I, the mean IOP was decreased from 25.5 ± 1.24 mmHg before treatment to 17.95 ± 1.23 mmHg in the last follow up visit. The average absolute reduction of IOP was 7.41 ± 0.839 mmHg. The average percent reduction of IOP was 29.8%. In group II ,the mean IOP was decreased from 21.32 ± 2.23 mmHg before treatment to 17.38 ± 1.56 mmHg in the last follow up visit.The average absolute reduction of IOP was 3.94 ± 0.7 mmHg.The average percent reduction of IOP in this group was 18.01%.
Conclusion:
SLT is nearly as effective as prostaglandins analogues, and proved a greater efficacy in IOP lowering when used as initial therapy for newly diagnosed eyes with POAG than when used as adjunctive therapy for eyes taking antiglaucoma medications with low baseline IOP.
Audience Take Away:
- Effective as prostaglandins analogues
- Proved a greater efficacy in IOP lowering when used as initial therapy for newly diagnosed eyes with POAG than when used
- Adjunctive therapy for eyes taking antiglaucoma medications with low baseline IOP
- This research could use to expand their research or teaching
