Trabecular Meshwork Stretching: An Alternative Therapy for Open Angle Glaucoma

Abstract

Purpose: : To evaluate safety, efficacy and repeatability of Pneumotrabeculoplasty (PNT).

Methods: : PNT is a novel technique that reduces intraocular pressure (IOP) stretching the trabecular meshwork. A suction ring is centered over the cornea and connected to a pump able to generate a vacuum of 20 mmHg. The vacuum applied over the cornea results in stretching of the trabecular meshwork and consequently lowering of the IOP. Thirty-two patients suffering from Primary Open Angle Glaucoma (POAG) were treated with PNT at day 1, day 7 and day 30. This protocol was repeated 3 times at six months intervals, and the IOP was a statistically reduction from a mean pre-treatment 19.02 mmHg to 16.32 mmHg post treatment

Results: : All patients completed 18 months of follow-up. Average IOP lowering effect was 16.6 % during each of the six months interval. No significant complications were observed. Ultra-Bio-Microscopy (UBM) showed shrinking of the ciliary body (CBT parameter) 1 mm from the scleral spur.

Conclusions: : PNT is a safe and effective technique for reducing intraocular pressure in patients with open angle glaucoma. Preliminary data supports using PNT as an adjunct treatment for patients with poor or no response to medical therapy. Larger study samples and longer follow-up are needed to confirm the results of this pivotal study.

Clinical Trial: : italia

Keywords: outflow: trabecular meshwork • intraocular pressure • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)