97th DOG Annual Meeting 1999



F. Weinand, A. Weber, K. W. Jacobi

The Selective Laser Trabeculoplasty (SLT) with the Q switched frequency doubled Nd-YAG Laser operating at 532 nm (Selecta 7000, Cohernt Inc, Palo Alto, CA) repesents a new treatment for patients with open angle glaucoma. The Selecta laser targets pigmented trabecular meshwork cells and increases their activity, thereby increasing aqueous outflow. Animal studies have shown that there is no damage to the trabecular meshwork.

Patients: Thirty-four eyes of 23 patients were treated in a prospective study with SLT with a follow up of 6 months (30 eyes with primary open angle glaucoma and 4 eyes with pseudoexfoliative glaucoma). We determined intraocular pressure and visual acuity as well as the antiglaucomatous drug therapy before, 2 and 24 hours, 1, 4 and 26 weeks after laser treatment.

Results: Twentyone eyes with identical drug regimen as that before treatment showed an IOP reduction of 13.5% on average. Two eyes with less medication than before SLT had an average decrease of 28.8%. On evaluation of the results we made a third group with 11 eyes with controlled IOP prior treatment (intraocular pressure less than 17 mmHg) but maximal drug therapy, multiple drug allergies or low compliance. This eyes failed treatment and developed a raised intraocular pressure of 55.0% on average. Two eyes needed filtrating surgery despite of being treated twice with SLT.

Conclusion: Selective Laser Trabeculoplasty offers a less traumatic alternative to argon laser trabeculoplasty. It is proven to be an effective method for treatment of uncontrolled open angle glaucoma. In eyes with IOP lower than 17 mmHg we noticed an increased IOP after a period of 6 month.

Justus Liebig University, Department of Ophthalmology, Friedrichstra├če 18, D-35385 Giessen