June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Comparison of intraocular pressure reduction after Argon Laser Peripheral Iridoplasty and combined Argon Laser Peripheral Iridoplasty with Selective Laser Trabeculoplasty in white patients
Author Affiliations & Notes
  • Johanna Orphal
    Department of Ophthalmology, University of Dresden, Dresden, Germany
  • Karin R Pillunat
    Department of Ophthalmology, University of Dresden, Dresden, Germany
  • Eberhard Spoerl
    Department of Ophthalmology, University of Dresden, Dresden, Germany
  • Lutz E Pillunat
    Department of Ophthalmology, University of Dresden, Dresden, Germany
  • Footnotes
    Commercial Relationships   Johanna Orphal, None; Karin Pillunat, None; Eberhard Spoerl, None; Lutz Pillunat, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 4979. doi:
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      Johanna Orphal, Karin R Pillunat, Eberhard Spoerl, Lutz E Pillunat; Comparison of intraocular pressure reduction after Argon Laser Peripheral Iridoplasty and combined Argon Laser Peripheral Iridoplasty with Selective Laser Trabeculoplasty in white patients. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4979.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To compare the intraocular pressure (IOP) lowering effect of Argon Laser Peripheral Iridoplasty (ALPI) and combined ALPI with Selective Laser Trabeculoplasty (SLT) in white patients with primary angle-closure glaucoma.

Methods : In this prospective case series, 18 eyes of 18 patients were included (mean age: 60.8±10.3 years). 8 patients received an ALPI and 10 patients a combined ALPI+SLT. The ALPI (Visulas 532s, Carl Zeiss Meditec AG, Jena, Germany) was performed over 360° of the peripheral iris with a spot size of 500 µm, a duration of 300 ms and a response-related titration of power of 200 - 400 mW. 24-30 spots were applied at the most peripheral part of the iris. In the group receiving an additional SLT (SoloTM, Ellex, Australia), 100 laser spots were applied over 360° of the trabecular meshwork with an average energy of 0.85 ± 0.10 mJ. IOP was measured before and 6 months after the treatment with Goldmann applanation tonometry in the course of diurnal IOP measurements at 1, 4, 7 and 10 PM and at 7 AM in a sitting position. IOP measurements at midnight were carried out in supine position. The average IOP of these 6 measurements (IOPm) was compared between both treatment groups. Statistical analysis was performed using SPSS. A P-value < 0.05 was considered statistically significant.

Results : After 6 months, 16 patients (89%) showed a reduction in IOPm. After sole ALPI the IOPm decreased from 18.7±5.8 to 14.4±2.4 mmHg (P=0.014). After combined ALPI+SLT the IOPm was reduced from 19.2±2.9 to 15.2±1.5 mmHg (P=0.006). There was no statistically significant difference in IOPm reduction between the treatment groups (P=0.817). The correlation between IOPm and baseline IOP was statistically significant (r=-0.912; P=0.001).

Conclusions : After 6 months, IOP reduction was similar after ALPI compared to ALPI+SLT in patients with primary angle-closure glaucoma. An additional SLT does not show a further IOP reduction. Presumably, the elimination of angle closure is the most important effect in these patients.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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