Abstract
Abstract: :
Purpose: SLT is a q-switched, melanosome specific laser used to lower intraocular pressure (IOP). Benefits over conventional ALT include markedly lower energy requirement, preservation of trabecular meshwork architecture, ease of use, and potential repeatability. We conducted a randomized clinical trial comparing efficacy and safety of SLT to ALT and now report longer follow-up data. Methods: 132 eyes with open angle glaucoma on maximal tolerated medical therapy were enrolled at the time of this analysis and randomized to undergo SLT and ALT using standard treatment parameters. Primary outcome was change in IOP from pretreatment baseline. Adverse events were recorded at all follow-up visits. Univariate and multivariate analyses were performed. Results: Baseline comparison was similar between SLT (n= 64) and ALT (n=68) groups including IOP (24.2 mmHg +/- 4.9 and 23.8 mmHg +/- 3.8, respectively). 12 month IOP drops were similar in the SLT (-6.5 +/- 0.83, n=52) and ALT (-5.7 +/- 0.64, n=55) groups as were 24 month IOP drops (SLT -4.5 +/- 1.17, n=38 vs. ALT -5.9 +/- 0.79, n=40). There was no statistically significant difference in IOP change between groups. There were an equivalent number of medication changes in each group. Adverse events were similar in the two groups: 15 eyes required trabeculectomies (8 SLT, 7 ALT), and 2 Ahmed valve procedures (both SLT). Conclusion: SLT appears to be equivalent to ALT in IOP lowering at 1 and 2 years. The incidence of adverse events was similar with SLT and ALT. Acknowledgement: Lumenis Inc. provided financial support for this study
Keywords: 454 laser • 444 intraocular pressure