Abstract
Purpose: :
Selective laser trabeculoplasty (SLT) is used to lower intraocular pressure (IOP) in patients with open-angle glaucoma (OAG) in addition or instead of local treatment by drops. We report a retrospective long-term evaluation of SLT efficacy.
Methods: :
Patients treated by SLT between 1997 and 1999 for OAG with sufficient follow up in our glaucoma center, were included. The procedure was performed with a Coherent Selecta 7000 Nd Yag with 100+/-10 non overlapping 400 µm spots over 360 degrees. Patients were excluded in case of prior filtration surgery or Argon laser trabeculoplasty.Patients were followed until change of medical treatment or additional laser or surgical intervention was required. Intraocular pressure (IOP) and number of glaucoma medications were noted at 6 months after SLT and every year for twelve years.Our primary outcome was failure of medical treatment and need of glaucoma filtration surgery. Our second outcome was IOP.
Results: :
We included 46 eyes of 28 patients. 15 men and 13 women. 26 patients were Caucasian and 2 were African. The mean age was 64.8 +/- 11 years. And the mean period between laser and glaucoma filtration surgery when performed was 7 years.26 % of the patients were medically controlled after 12 years, 39 % needed surgery (glaucoma or combined cataract and glaucoma) . No significant complications were noted.Mean IOP was 22.8+/- 3.78 mmHg before laser and 16.08+/-2.7 mmHg at 1 year; 15.6+/-2.23mmHg at 3 years, 15.42+/-1.86 mmHg at 5 years; 15.16+/-1.89 mmHg at 8 years; 16+/-2.28 mmHg at 10 years and 15+/-1.8 mmHg at 12 years.The mean number of medication was 1.6+/-0.8 before SLT and respectively 1.36+/-0.8 at 1 year, 1.4+/-1 at 3 years, 1.5+/-1.3 at 5 years, 1.2+/-1.2 at 10 years and 1.3+/-1.2 at 12 years after SLT.
Conclusions: :
SLT is a safe and effective method to lower IOP in patients with glaucoma and allows a decrease in medical treatment. SLT seems to delay the necessity for filtering surgery.
Keywords: laser • intraocular pressure • trabecular meshwork