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Miho Nozaki, Shuichiro Hirahara, Yuichiro Ogura; Patterned Laser Trabeculoplasty with PASCAL streamline 577. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1867.
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Patterned Laser Trabeculoplasty (PLT), the computer-guided laser trabeculoplasty is a newly developed treatment modality using PASCAL® (Topcon Medical Laser Systems, Santa Clara, CA, USA). PLT with PASCAL streamline® (532 nm) has been reported as precise and minimally traumatic treatment, and exhibiting a 24% reduction in intraocular pressure (IOP) (Turati M, et al, Ophthalmic Surg Lasers Imaging, 2010). The purpose of this study is to evaluate the efficacy and safety of the PLT with yellow wavelength PASCAL (PASCAL Streamline 577®) for open-angle glaucoma.
Eleven eyes of 9 patients with open-angle glaucoma received 577-nm laser treatment with 100-μm spots. Five men and four female (mean age, 65 years) were included and average follow-up period was 6.8 months. Power was titrated for trabecular meshwork blanching at 10 ms and sub-visible treatment was applied with 5-ms pulses. The arc patterns of 66 spots rotated automatically after each laser application so that the new pattern was applied at an untreated position. We evaluated pre- and postoperative IOP, medication score, and laser setting parameter.
Approximately 1,287 laser spots were placed per eye in 16 steps, covering 360° of trabecular meshwork. The IOP significantly decreased from the pretreatment level of 20.5 ± 4.7 to 15.0 ± 2.1 mm Hg at one month (p<0.01, t-test) and remained until 6 months (13.4± 3.7 mmHg, p<0.05). The IOP reduction rate was 37.2 % at the last examination. There was no significant difference in pre- and postoperative medication score (2.6 and 2.8 respectively). One eye developed transient IOP elevation (9%) after PLT, but there was no eye showed peripheral anterior iris synechia or corneal endothelial damage after PLT.
Our data showed that PLT using 577-nm PASCAL is a safe computer -guided laser treatment, and might be useful to lower the IOP for open-angle glaucoma. A Longer follow-up should be required for future.
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