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Sara Aurora Garcia y Otero Sánchez, Jose A Paczka, fabiola Garcia-y-Otero, Julio Moreno- Nava, Luz America Paczka-Giorgi; Angle-Closure Glaucoma Treated with Selective Laser Trabeculoplasty. Report of Efficacy and Safety after One-Year.. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2573.
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Selective laser trabeculoplasty (SLT) enhances outflow facility but depends on angle openness to be performed. Any angle-closure glaucoma (ACG) is not a good candidate for SLT, although if angle shallowness is reversed by any means, laser energy can be applied in the trabecular tissue and have a therapeutic effect. The aim of this retrospective study was to investigate the results of SLT in patients with angle-closure glaucoma with accessible angle view after a procedure to deepen the anterior chamber.
A retrospective assessment of the medical records of consecutive angle-closure glaucoma cases treated with SLT was performed in a specialized center in western Mexico. Forty-five cases from 26 patients were selected; using the data of one eye per patient, selected in at random. Baseline data and information from the follow-up visits for one year were analyzed. The studied variables were best-corrected visual acuity (BCVA), Goldmann IOP, number of antiglaucoma medications, collateral procedures (surgery/laser), visual field indexes, cup to disc (CD) ratio, thickness of retinal nerve fiber layer (RNFL), thickness of the ganglion cell layer, success procedural rate (pre-established criteria) and presence of complications.
Patients included in the study (14 females, 12 males) had a mean age of 63.0±10.1 years. Mean time from prior anterior chamber deepening procedure (8, iridotomy; 6, iridoplasty; 5, phaco+IOL, 5, iridotomy+ iridoplasty; 2, iridotomy+phaco+IOL) and SLT was 12.8±10.0 months. Baseline IOP (19.1, S.E. 0.38 mmHg) was significantly less (p=0.001) than all five post-SLT timepoints (table 1). No significant changes in the BCVA (p=0.18), VFI (0.11), RNFL (0.13), and CD ratio (0.40) were found before and after the laser procedure. Baseline number of glaucoma medications (median, 2; range, 1-4) was significantly greater as compared to the last visit (median, 2 ; range 1-3; p=0.0001). Success rate at one year was 65.4%. A transient IOP spike occurred in only 2 cases and was solved with a conservative approach. No other complications were recorded.
According to the current results, SLT could be offered as a good additive treatment for angle-closure glaucoma when the irido-corneal angle can be adequately viewed after an anterior chamber deepening procedure is performed.
This is a 2021 ARVO Annual Meeting abstract.
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