Selective laser trabeculoplasty in exfoliative glaucoma eyes with prior argon laser trabeculoplasty. 2020

Lotta Ilveskoski, and Claudia Taipale, and Raimo Tuuminen
Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland.

OBJECTIVE To explore the efficacy of selective laser trabeculoplasty (SLT) within eyes with exfoliative glaucoma and history of prior argon laser trabeculoplasty (ALT). METHODS A single-centre trial consisting of 47 patients (47 eyes) with uncontrolled exfoliative glaucoma. The main outcome measure was intraocular pressure (IOP) reduction 3 and 9 months after SLT. Treatment success was defined as reduction from the preoperative IOP by 20% and 2 mmHg (<12 mmHg), 3 mmHg (12-16 mmHg) or 4 mmHg (>16 mmHg) depending on the baseline IOP. RESULTS Patient age was 79.3 ± 7.6 years (mean ± SD) and gender distribution 15 males and 32 females. The mean pre-SLT IOP was 15.6 ± 5.1 (range 9-28) mmHg, and mean number of glaucoma drugs 2.0 ± 1.2. The mean interval between prior ALT and SLT was 44.0 ± 36.9 (range 11-137) months. After SLT, the mean IOP change was -2.7 ± 4.2 mmHg (-14.8 ± 23.5%) at 3 months, and -2.8 ± 3.5 mmHg (-16.3 ± 19.4%) at 9 months. Pre-SLT IOP correlated with the IOP reduction at 3 months (r = 0.530, p < 0.001) and at 9 months (r = 0.432, p = 0.007). The overall success rate was 50% at 3 months, and 42% at 9 months. At both 3 and at 9 months, the cut-off level for treatment success was achieved when preoperative IOP was 18 mmHg and above. IOP lowering effect of SLT did not correlate with the number of glaucoma drugs, age, gender or use of prostaglandin inhibitors. Neither postoperative iritis nor other adverse effects were documented during the follow-up. CONCLUSIONS Selective laser trabeculoplasty is a safe and noteworthy treatment option to reduce IOP in exfoliative glaucoma eyes, especially with pre-SLT IOP over 18 mmHg.

UI MeSH Term Description Entries
D007429 Intraocular Pressure The pressure of the fluids in the eye. Ocular Tension,Intraocular Pressures,Ocular Tensions,Pressure, Intraocular,Pressures, Intraocular,Tension, Ocular,Tensions, Ocular
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011184 Postoperative Period The period following a surgical operation. Period, Postoperative,Periods, Postoperative,Postoperative Periods
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D014129 Trabecular Meshwork A porelike structure surrounding the entire circumference of the anterior chamber through which aqueous humor circulates to the SCHLEMM'S CANAL. Meshwork, Trabecular,Meshworks, Trabecular,Trabecular Meshworks
D014130 Trabeculectomy Any surgical procedure for treatment of glaucoma by means of puncture or reshaping of the trabecular meshwork. It includes goniotomy, trabeculectomy, and laser perforation. Goniotomy,Trabeculoplasty,Trabeculotomy,Goniotomies,Trabeculectomies,Trabeculoplasties,Trabeculotomies

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