April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Excimer Laser Trabeculostomy: One Year Post-OP Efficacy in 166 Eyes
Author Affiliations & Notes
  • Richard P. Stodtmeister
    Ophthalmology, University Hospital Carl Gustav Carus, Dresden, Germany
  • Lea Kleineberg
    Augenklinik Detmold GmbH, Detmold, Germany
  • Michael S. Berlin
    Glaucoma Institute Beverly Hills, Los Angeles, CA 90048, California
  • Lutz E. Pillunat
    Ophthalmology, University Hospital Carl Gustav Carus, Dresden, Germany
  • Ulrich Giers
    Augenklinik Detmold GmbH, Detmold, Germany
  • Footnotes
    Commercial Relationships  Richard P. Stodtmeister, None; Lea Kleineberg, None; Michael S. Berlin, patent expired: May 2007 (P); Lutz E. Pillunat, None; Ulrich Giers, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 2630. doi:
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      Richard P. Stodtmeister, Lea Kleineberg, Michael S. Berlin, Lutz E. Pillunat, Ulrich Giers; Excimer Laser Trabeculostomy: One Year Post-OP Efficacy in 166 Eyes. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2630.

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

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Abstract

Purpose: : Excimer Laser Trabeculostomy (ELT) is a novel surgical treatment for open angle glaucoma in which openings are created ab interno through the trabecular meshwork into Schlemm’s canal.

Methods: : Ab interno trabeculostomy (ELT) was performed using a 308 nm excimer laser on 166 eyes of 166 patients with primary open-angle glaucoma or secondary glaucoma aged 70±13 years. All surgical procedures were performed by a single surgeon .308 nm excimer laser energy is delivered by a 200-µm fiber in a 500-µm probe crossing the anterior chamber via a superior temporal limbal paracentesis which contacts the infero-nasal trabecular meshwork to create 10 openings by non-thermal photoablation. Intra-ocular pressure (IOP) was measured pre-op and at: 1 week (160 eyes), 1 month (151 eyes), 3 months (142 eyes), and 1 year (130 eyes).

Results: : Pre-operative intra-ocular pressure (IOP) of 26.4 (±6.2) mmHg; was reduced after 1 week to 19.1 (±8.7); after 1 month to 18.8 (±6.2); after 3 months to 18.2 (±5.8); and after 1 year to 16.9 (±4.7). The pressure reduction was statistically significant at all time points (variance analysis, Bonferroni correction, alpha: p<0.00001). The average number of anti-glaucoma medications was the same (1.5±1.2) both before and after ELT surgery.

Conclusions: : Excimer Laser Trabeculostomy appears to be safe and effective in lowering IOP for at least one year in primary open-angle and secondary glaucoma. The intra- and post-operative complications are significantly less than in trabeculectomy. In addition, ELT does not interfere with the subsequent performance of any other pressure-lowering surgical procedures if necessary. No additional procedures were needed in any patients in this cohort.

Keywords: laser • trabecular meshwork • intraocular pressure 
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