ESCRS - FP08.07 - Aqueous Humor Outflow Improvement After Excimer Laser Trabeculostomy

Aqueous Humor Outflow Improvement After Excimer Laser Trabeculostomy

Published 2025 - 43rd Congress of the ESCRS

Reference: FP08.07 | Type: Free paper | DOI: 10.82333/8msf-ah23

Authors: Arpita Kulshrestha* 1 , Parul Chawla Gupta 1 , Amit Gupta 1 , Chintan Malhotra 1

1Ophthalmology,Post Graduate Institute of Medical Education & Research,Chandigarh,India

Purpose

To investigate the changes in aqueous humor outflow (AHO) after the Elios glaucoma procedure using sequential aqueous humor outflow angiography

Setting

Prospective clinical study.

Methods

Sequential AHO angiography using 2 different tracers was performed in 10 patients undergoing routine combined cataract + MIGS surgery including the Elios glaucoma procedure. After cataract surgery, baseline AHO angiography pattern were acquired using a digital angiography camera and indocyanine green as tracer. The Elios procedure was performed according to the manufacturer’s recommendations. Subsequently, a second AHO angiography using fluoresceine was used  to assess potential changes in the outflow patterns. Images were acquired at predefined time points (15, 30, 45, 60, 90, 120 seconds after dye injection). AHO signal intensity was analyzed (with ImageJ) in the images taken after 60 seconds in a region of interest placed nasally. 

Results

In all 10 eyes, AHO angiography images were acquired successfully. A positive AHO signal could be detected in all eyes. The average signal intensity was 11.41 +/- 2.92 (mean +/- std. dev.) before and 25.56 +/- 10.51  after the surgical intervention (p = 0.022, two-sided paired t-test). The AHO improvement was located in the nasal quadrant at the location of the laser treatment or adjacent to the laser spots, but no strict 1:1 relationship was observed between laser application spots and AHO improvement.

Conclusions

The Elios procedure increased AHO outflow in all eyes investigated. Further studies are needed to correlate the AHO improvements seen to the clinical efficacy of the procedure.