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Results of selective laser trabeculoplasty (SLT) as initial or adjunctive treatment for primary open-angle glaucoma

Poster Details

First Author: H.Yener TURKEY

Co Author(s):    C. Caglar   A. Gul   M. Ozcimen        

Abstract Details



Purpose:

To evaluate the efficacy of selective laser trabeculoplasty (SLT) for the initial or adjuntive treatment of primary open-angle glaucoma (POAG).

Setting:

Konya Medicana Private Hospital, Eye Clinic.

Methods:

We analyzed the results of SLT in 162 eyes of 81 patients diagnosed with POAG. Patients were divided into two groups: patients with confirmed glaucoma on medical therapy (group 1) and recently diagnosed cases with no preoperative medications (group 2). SLT was performed as adjuntive treatment in 42 POAG patients (84 eyes; Group 1) and as initial treatment in 39 POAG patients (78 eyes; Group 2). All procedures were performed by HİY in Konya Medicana Hospital Glaucoma Clinic from January of 2012 to July of 2013. Patients were treated using the Coherent Selecta 7000 laser, a frequency-doubled q-switched Nd:YAG laser (Coherent, Palo Alto, CA) emitting at 532 nm with a pulse duration of 3 nsec and a spot size of 400 mm, coupled to a slit-lamp delivery. All patients underwent 360° SLT. Patients were followed up at 1 week, 1, 3, 6 and 12 months after treatment. IOP was measured by Goldmann applanation tonometer. The follow-up time was 49.85±8.2(24-78) weeks. The data were analyzed by software SPSS 16.0. Paired Student t tests were used to compare IOP values before and after SLT, age, gender, central corneal thickness and follow-up time in per group. P value <0.05 was considered statistically significant.

Results:

When age, gender, central corneal thickness and follow-up time were considered, there were no statistical difference in both groups. The IOP was 23.3±4.8 (10-35) mmHg before SLT and 14.6±2.7 (8-22) mmHg in the last visit for all eyes. Mean final IOP at the end of the study was statistically significantly lower than the pretreatment mean IOP (P<0.05). We further compared the mean IOP for each group. Group I (adjunctive treatment group) had a preoperative mean IOP of 22.9±5.2 (10-34) mmHg that decreased significantly to 15.0±2.6 (10-22) (P<0.001). IOP decreased significantly in Group II (primary treatment group) from 23.8±4.4 (14-35) mmHg preoperatively to 14.2±2.8(8-21) mmHg by the end of the study (P=0.001). Among patients using preoperative medications (group 1), the mean number of medications used dropped statistically significantly throughout the study from 2.11±0.88 (1-4) before the procedure to 0.9±0.15 (0-3) at the end of 18 months follow-up (P= 0.004). In group 1, using our definition of success of decreasing or cut-off glaucoma medications, 60 of 84 (71.5%) were successful at last visit. In group 2, using our definition of success of not starting to glaucoma medication after SLT procedure 51 of 78 (65.3%) were successful at last visit.

Conclusions:

SLT can be safely and effectively used as primary or adjunctive therapy for the treatment of POAG. SLT was also effective in reducing the number of medications used by patients which is an economic advantage in developing countries. The IOP-lowering effect of SLT was similar in both groups. FINANCIAL INTEREST: NONE

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