Evaluation Of Early Outcomes Following Introduction Of Excimer Laser Trabeculostomy (Elt) In Four Uk Centres
Published 2024 - 42nd Congress of the ESCRS
Reference: PO1021 | Type: Free paper | DOI: 10.82333/vc7w-3254
Authors: Guy Mole 1 , Panagiotis Dervenis 2 , Chrysostomos Dimitriou 2 , Luisa Roger 3 , Neeru Vallabh 3 , Claudia Quijano 4 , Dan Lindfield 4 , Gokulan Ratnarajan* 1
1Glaucoma,Queen Victoria Hospital NHS Foundation Trust,East Grinstead,United Kingdom, 2Glaucoma,East Suffolk and North Essex NHS Foundation Trust,Colchester,United Kingdom, 3Glaucoma,Liverpool University NHS Foundation ,Liverpool ,United Kingdom, 4Glaucoma,Royal Surrey County Hospital ,Guildford,United Kingdom
Purpose
ELT is a novel technique for enhancing outflow through the trabecular meshwork which can be performed as a standalone procedure or combined with cataract surgery. The concept uses a 308nm xenon chloride excimer laser with a non-thermal approach creating 10 trabeculostomies and leaving no implant in the eye. There are published studies as far as back as 2006 using ELT but this technique has only recently become available in the UK and we report early results from four centres.
Setting
Four National Health Service (NHS) hospitals offering a specialist glaucoma service.
Methods
We collected real world retrospective data from four UK sites looking at demographics, intraocular pressure, number of medications and adverse events. Previous studies have shown the pressure reduction at 3 months is largely maintained at 2 and 5 years.
Results
Our cohort contained 107 eyes of which 53 (49.5%) were right eyes and 54 (50.5%) left eyes with an average age of 77. 44 (41.1%) were male and 63 (58.9%) female with 2 (1.9%) performed as standalone procedures and the remainder combined with cataract surgery. 73 (68.2%) of eyes had a diagnosis of primary open angle glaucoma, 14 (13.1%) primary angle closure glaucoma, 8 (7.5%) pseudoexfoliation glaucoma, and 10 (9.4%) other diagnoses.
Mean pre-op IOP was 18.53mmHg (SD+/- 4.62) with the mean number of eye drops 1.72 (SD+/-1.04). At 1 month the mean IOP was 16.06 (p<0.001) with a mean 0.93 eye drops. By 3 months the mean IOP was 14.17 (p<0.001) on a mean of 0.89 drops.
Conclusions
The early UK experience from 4 sites shows an average ~25% drop in IOP at 3 months (p<0.001) with on average one fewer anti-hypertensive medications than pre-op. There were no serious complications in our cohort of over 100 patients. These early results, in line with previously published studies, shows ELT to be safe and effective with the added advantage of not leaving an implant in the eye making it an attractive MIGS option.