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Giovanni Milano, Alice Chandra Verticchio Vercellin, Sara Lombardo; Safety and efficacy of the Computer Guided Patterned Selective Laser Trabeculoplasty (PSLT). Invest. Ophthalmol. Vis. Sci. 2016;57(12):6482.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the safety and efficacy of the PSLT using PASCAL ® Photocoagulator System (stream line: 577 nm) in Open Angle Glaucoma (OAG) patients.
34 eyes of 34 consecutive OAG patients (13 male; mean age: 69.85 ± 8.99 years; primary OAG: 31; exfoliative glaucoma: 2; pigmentary dispersion glaucoma: 1) not reaching the target pressure with medical therapy alone (mean number of active principles: 2.86 ± 0.85), were treated with PSLT. The treatment is guided by the computer and covered 180° of the trabecular meshwork (TM) in 11 eyes and 360° in 23 eyes. The intraocular pressure (IOP) has been evaluated with Goldmann applanation tonometry before (t0), one hour (t1), one week (t2), one month (t3), three months (t4) and six months (t5) after treatment. Wilcoxon signed-rank test was used to test IOP differences from t0, statistically significant if p<0.05.
The eyes evaluated at t0 and t1 were 34, at t2 26, at t3 24, at t4 14 and at t5 12. The mean IOP were: 17.58 mmHg at t0, 17.47 at t1, 14.62 at t2, 16.96 at t3, 15 at t4, 15.25 at t5. A significant difference was reached only at t2 (p< 0.05). The IOP reduction at t4 and t5 was 15% compared to t0. No patient had IOP spikes or ocular pain , nor TM visible scarring at any time after treatment.
In this cohort of patients, PSLT has been a safe and well tolerated method to reduce IOP in OAG patients, even safer than Argon Laser trabeculoplasty considering the reduced tissue damage. Reducing IOP by 15%, was less than expected from previous studies (20-30%). This can be due to the small number of patients who completed the follow-up and to the high number of medications used that can modify the TM sensitivity to the biologic effect induced by SLTP.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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