Efficacy And Safety Of Combined Excimer Laser Trabeculostomy And Phacoemulsification: A 12-Month Prospective Study
Published 2025 - 43rd Congress of the ESCRS
Reference: FP22.02 | Type: Free paper | DOI: 10.82333/gmv7-tr15
Authors: Mona El Zarif* 1 , Mario Nubile 2 , Niccolò Salgari 3 , Michele Totta 4
1Ophthalmology Clinic, Department of Medicine and Aging Sciences,University "G. D'Annunzio" of Chieti-Pescara,Chieti,Italy;Department of Medicine and Aging Science, Center for Advanced Studies and Technology-CAST,University G. d’Annunzio of Chieti-Pescara,Chieti,Italy;Genomic Surveillance and Biotherapy GSBT, Faculty of Sciences,Lebanese University,RasMaska,Lebanon;Doctoral School of Sciences and Technology,Lebanese University,Hadath,Lebanon, 2Department of Medicine and Aging Sciences,University "G. D'Annunzio" of Chieti-Pescara,Chieti,Italy, 3Department of Translational Medicine,University of Ferrara,Ferrara,Italy;Department of Ophthalmology,Ospedali Privati Forlì “Villa Igea”,Forlì,Italy;Istituto Internazionale per la Ricerca e Formazione in Oftalmologia (IRFO),Forlì,Italy, 4Ophthalmology Clinic, Department of Medicine and Aging Sciences,University "G. D'Annunzio" of Chieti-Pescara,Chieti,Italy
Purpose
Minimally invasive glaucoma surgeries (MIGS) offer a safer alternative to traditional filtering procedures for intraocular pressure (IOP) control. Excimer laser trabeculostomy (ELT) enhances aqueous outflow by creating ablation channels in the trabecular meshwork and Schlemm’s canal. Combining ELT with phacoemulsification (phaco-ELT) in patients with concurrent cataract and open-angle glaucoma (OAG) mayoptimize outcomes. This study evaluates the 12-month efficacy of phaco-ELT in reducing IOP, decreasing the needfor topical hypotensive medications, and achieving qualified success.
Setting
This 12-month prospective study is being conducted at SPKSO, a tertiary eye hospital in Warsaw, equipped with state-of-the-art diagnostic and surgical facilities. The study aims to assess the efficacy and safety of combined excimer laser trabeculostomy and phacoemulsification in patients with primary open-angle glaucoma (POAG).The goal is to evaluate the impact of this combined approach on intraocular pressure reduction, medication use, and postoperative outcomes in this patient population.
Methods
This prospective interventional study included 14 eyes from 14 patients with mild-to-moderate OAG who underwentphaco-ELT. Primary outcomes were IOP reduction and changes in glaucoma medication burden at 12 months. Qualified success was defined as an IOP <18 mmHg with a ≥20% reduction from baseline, with or without medication use. Secondary outcomes included safety assessment and postoperative complications. IOP and medication use were recorded preoperatively and postoperatively at 1 day, 1 month, 3 months, 6 months, 9 months, and 12 months. Friedman’s test and Wilcoxon signed-rank tests were used for statistical analysis.
Results
Phaco-ELT effectively and safely reduces IOP and medication burden over 12 months. While no patient achieved complete success, all patients reached qualified success, highlighting the efficacy of phaco-ELT in IOP control with minimal medication dependence. The results support phaco-ELT as a reliable MIGS option in patients with coexisting cataract and OAG.
Conclusions
Phaco-ELT provides significant and sustained IOP reductionwhile reducing medication burden. It demonstrates a 100% qualified success rate, making it a promising approach for glaucoma management. Further randomized controlled trialsare needed to confirm long-term benefits.