Abstract
Purpose: :
Ab interno Excimer Laser Trabeculostomy (wavelength 308 nm) is used to create ten openings in the trabecular meshwork and inner wall of Schlemm’s canal following phacoemulsification with lens implantation (Phaco + IOL).
Methods: :
37 eyes of 37 patients, age 74.4 ±5.1 years with open angle glaucoma were included in a planned, prospective study. The intraocular pressure (IOP) was measured pre-op and 1 day, 1, 3, 6, 12, 24, 36, 48, and 60 months (M) post-op. Operation procedure: Following Phaco + IOL, the ELT probe traverses the anterior chamber from a supero-temporal paracentesis to enable 10 applications in the lower nasal quadrant. Number of eyes monitored were as follows: 12 M: 37 eyes; 24 M: 36; 36 M: 33; 48 M: 31 and 60 M: 28.
Results: :
IOP (mm Hg) pre-op 23.3 ± 5.9; 1 day 14.9 ± 5.3; 1 M 12.9 ± 2.4; 3 M 12.5 ± 2.2; 6 M 13.3 ± 2.5; 12 M 12.7 ± 2.8; 24 M 13.3 ± 2.2; 36 M 13.4 ± 2.0; 48 M 14.1 ± 2.6; 60 M 14.3 ± 2.6. The data were normally distributed. Statistical tests: ANOVA with repeated readings, SPSS 17.0 (Bonferroni correction). At each measuring time the IOP readings were significantly lower than pre-op (α<0.001)
Conclusions: :
The lowering of the IOP of our patients was of the same order of magnitude as in other similar, shorter duration combined ELT studies, however the effective pressure lowering in this study has been documented to remain stable for 5 years post-op. After 5 years, a small increase in IOP is noted which is statistically insignificant.
Clinical Trial: :
www.doc4eye.de, 15204
Keywords: trabecular meshwork • laser • cataract