Excimer Laser Trabeculoplasty (Elt) For Reducing Intraocular Pressure In Glaucoma Patients: A Case Series

The purpose of this study is to present the efficacy of Excimer Laser Trabeculoplasty (ELT) in reducing intraocular pressure (IOP) in patients with primary open-angle glaucoma.

The procedures were performed in the Glaucoma Unit of the Ophthalmology Department at Hillel Yaffe Medical Center on two patients (three eyes) with moderate to advanced Primary open angle glaucoma, with uncontrolled intraocular pressure under Maximally tolerated medical therapy. 

The procedure was executed using an excimer laser system which uses a 308-nm xenon chloride (XeCl) excimer laser to create ten 200-μm trabeculostomy openings (laser channels) through the TM and inner wall of Schlemm’s canal with an estimated treatment depth of 20 μm . The short pulse energy applied with Extra ELT is 1.2–1.3 mJ with a duration of 80 ns. Patients were closely monitored post-operatively. IOP measurements were taken at regular intervals over six months.

Two patients with moderate to advanced  primary open-angle glaucoma underwent ELT. The pre-procedure IOP readings for the three affected eyes were 27 mmHg, 25 mmHg, and 25 mmHg, respectively. The post-procedure IOP levels were recorded at 14 mmHg, 20 mmHg, and 18 mmHg, respectively. This demonstrates an average decrease in IOP of 32 %. Additionaly, the number of glaucoma medications required by the patients did not change during the follow-up period.

Excimer Laser Trabeculoplasty (ELT) appears to be an effective and safe option for reducing intraocular pressure in patients with glaucoma. The significant reduction in IOP observed in this case study, maintained over a six-month follow-up period without an increase in glaucoma medications, highlights the potential of ELT as an adjunctive or alternative treatment for glaucoma management