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Ohoud A Owaidhah, Leyla Ali Aljasim, Deepak P Edward; The efficacy of selective laser trabeculoplasty (SLT) in primary angle closure glaucoma (PAC/PACG): a case control study.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6157.
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Many studies have reported on the efficacy of SLT in open angle glaucoma. A single case series suggested that SLT may be effective in controlling IOP in PACG. We hypothesized that SLT might be as effective in reducing intraocular pressure (IOP) in a safe manner in patients with PAC/PACG following a YAG PI as it is in open angle glaucoma (OAG).
In a case control study we studied the effectiveness of SLT in PAC/PACG and compared its efficacy to that in OAG. Data from patients who underwent SLT after a successful YAG PI for PAC/ PACG with opening of the angle for at least 180o degrees were compared to an OAG group that was randomly matched to the PAC/ PACG group for age & baseline IOP, previous surgeries & severity of glaucoma. The change in IOP from baseline and reduction in number of medications following SLT in both groups was computed.
In the PAC/PACG group 63 eyes (62±10 years old) with persistent IOP elevation following successful YAG PI underwent SLT in areas where the angle was open; 40% of PAC/PACG has scattered PAS less than 180o*degrees; In the OAG group, 63 underwent SLT( 60±13 years old ). 64% in PAC/PACG & 85.5% in POAG had 360* treatment, with 76±16 and 79±14 shots, 0.5 & 0.6 mj per shot respectively. The baseline IOP in the PAC/PACG group was 19±6 mmHg, decreased to 15±3mmHg at 10±3 months following SLT & the number of medication decreased from 2.3 to 1.5. In the OAG group baseline IOP 17±4mmHg, which was statistically not different from baseline IOP in PAC/PACG ( p=0.15), reduced to 15±3mmHg, at 10±2 months following SLT and the glaucoma medications were reduced from 2.6 to 1.3. The IOP reduction between PAC/PACG & POAG following SLT was not significantly different (p=0.655). A greater percentage reduction in IOP was achieved when SLT was performed as a primary procedure in PAC/PACG (33.6%; n=5) and OAG (22.7% n=3), and less reduction when patient was on antiglaucoma treatment but had uncontrolled IOP, in PAC/PACG (23.9%, n=26), OAG (18.2%, n=21). Nine eyes with PAC (14%) and 8 (12%) in the OAG group failed SLT treatment. An IOP spike was noted in 6 eyes with PACG/PAC and 3 eyes with OAG and was controlled with topical medications.
SLT in PAC/PACG was as effective and safe as SLT in OAG
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