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M. G. Uva, A. Longo, M. Reibaldi, A. Reibaldi; Efficacy of Pneumotrabeculoplasty in Primary Open Angle Glaucoma and Ocular Hypertension. Invest. Ophthalmol. Vis. Sci. 2007;48(13):863.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the efficacy and safety of Pneumotrabeculoplasty (PNT) in the treatment of Primary Open Angle Glaucoma (POAG) and Ocular Hypertension (OH)
From June 2005 to September 2006, 25 eyes of 19 patients, affected by POAG or OH were treated by PNT. All patients aged more than 65 years, had visual acuity 1.0, refraction < ± 2D, IOP between 20 and 25 mmHg (with two topical therapies), C/D < 0.6, MD < 12 dB (24-2 full threshold, Humphrey visual field). Were excluded patients with other ocular pathologies or therapies, previous ocular parasurgical or surgical treatments; patients with diastolic blood pressure < 70 mmHg, previous vascular occlusion and other circulatory pathologies were also excluded. In topical anaesthesia, with the patient in supine position, a disposable plastic suction ring, connected to a vacuum pump (PNT Unit 1000-Coronado, Ophthalmic International Inc, Fountain Hills, Arizona, USA) was applied on the eye. Vacuum, settled to 20 inches, was applied for 60 seconds, and then the ring removed; the procedure was repeated after 5 minutes. The whole treatment was repeated after 1 week. All patients give informed consent.The following parameters were evaluated after 1 week and 1, 3, 6 and 9 months: intraocular pressure, visual acuity, visual field, anterior and posterior segment findings.
Mean follow-up was 8.2 + 2.2 months. Intraocular pressure (baseline 22.8 + 1.8 mmHg) reduced significantly (ANOVA p=0.000). Mean IOP decrease was at 1 week 4.4 + 2.1 mmHg (-19.1 + 9.2%), at 1 month 4 + 1.9 mmHg (-17.5 + 8.3%), at 3 months 3.9 + 1.9 mmHg (-17.1 + 8.1%), at 6 months 3.7 + 2 mmHg (-15.7 + 8.2%) and at 9 months 3.2 + 1.7 mmHg (-13.9 + 7.2%); an IOP decrease ≥ 20% was found respectively in 15/25 (60%), 13/25 (52%), 12/25 (48%), 6/19 (32%) and 3/11 eyes (27%). After 9 months 8/11 eyes had IOP<20 mmHg. After the treatment no patients had visual acuity reduction and ocular inflammation; in 5 eyes a subconjunctival hemorrhage was found. No posterior segment changes and visual field progression were detected after the treatment.
Pneumotrabeculoplasty is a safe technique allowing a significant IOP reduction, probably by an increase of outflow. Further studies have to identify the good responders patients, and the efficacy of a retreatment.
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