97th DOG Annual Meeting 1999
SELECTIVE LASER TRABECULOPLASTY - RESULTS DURING THE FIRST TWO YEARS
P. Kaulen, A. Richter, C. Wiemer
To investigate the time course of IOP and successrate in different types of glaucoma treated with selective laser trabeculoplasty (SLT) which represents a new method in the treatment of glaucoma.
Methods: 460 eyes of 328 patients were treated with a frequency doubled, Q-switched Nd:YAG-laser (523 nm) using a total energy of 65-125 mJ. Spots of 400 µm diameter were applied to the trabecular meshwork. Success was defined as a more of 20% reduction of IOP or reduction of the number of topical drugs with unchanged IOP.
Results: Mean reduction of IOP was 35% in pseudoexfoliation syndrome (PEX), 23% in primary open angle glaucoma (POAG), 17% in normal tension glaucoma (NTG) and 17% in patients pretreated with argon laser trabeculoplasty (ALT). Successrates after 2 years as determined from Kaplan-Meier-plots were 84% in PEX, 81% in POAG, 51% in ALT pretreated eyes and 40% in NTG. IOP reduction correlated with the degree of angle pigmentation and age of patients. Most common side effect (11/460) was the elevation of IOP (>10 mmHg) in the second postoperative week, which was easily controlled by topical steroids.
Conclusion: SLT is a safe and successful method in the treatment of POAG and PEX. SLT can be performed after unsuccessful ALT and may delay or substitute the necessity of glaucoma filtering surgery. The role of SLT in the therapy of other forms of glaucoma remains to be determined.
Augenarztpraxis, Drakestr. 32, D-12205 Berlin-Lichterfelde