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Syed Naqib Ahmed, Syed Mohammed Shahid, Sam Kanavati, Syed Ahmed, Julian Hickman-Casey; Assessing the effectiveness of PASCAL Laser Trabeculoplasty in the management of glaucoma. Invest. Ophthalmol. Vis. Sci. 2019;60(9):695.
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Laser trabeculoplasty is a recommended treatment option for the management of glaucoma. First-line treatment for glaucoma is with drops and using laser is recommended if intra-ocular pressure (IOP) is insufficiently reduced with medication or patients are intolerant to medications. Current NICE guidelines in the UK recommend selective laser trabeculoplasty (SLT) or argon laser trabeculoplasty (ALT) as options for lowering IOP in patients.Studies have, however, documented the possibility of pattern scanning laser trabeculoplasty (PSLT) providing a significant alternate. Suggested benefits of PSLT over ALT are reduced damage to the trabecular meshwork and improved patient comfort. Our study evaluates the effectiveness of Pascal laser in lowering IOP and reducing the need for multiple medications at a district general hospital. There is limited information regarding the use of the pascal laser for glaucoma in a real world situation.
A retrospective study was performed using the hospitals electronic medical records. All patients that had PSLT using Pascal laser from the time period of August 2016 to September 2018 were analysed. Sixty-four patient records were initially identified, with some patients having received bilateral laser therapy. Results from a total of seventy eyes were henceforth analysed. Data collected included patient demographics, pre-operative IOP and last recorded IOP. The number of glaucoma medications used by patients pre and post-operatively was also analysed.
The mean reduction in IOP was 3.87 mmHg. Patients with data on follow-up for two years showed a mean reduction of 3.45 mmHg. Thirty of the seventy eyes treated subsequently reduced the number of glaucoma drops required, with a further seven eyes remaining drop free post-treatment.
Results from our study show that pattern scanning laser trabeculoplasty using Pascal Streamline laser 577 is effective in lowering IOP in the management of glaucoma. The use of PSLT can help reduce the need for further treatment post-laser and can provide an alternative treatment option for patients that are non-compliant with medication, and not suitable for trabeculectomy procedures. The procedure also provides an alternative first-line approach in the management of glaucoma.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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