Efficacy And Safety Of Direct Selective Laser Trabeculopasty: 1 Year Follow Up Results

To evaluate the efficacy and safety of direct selective laser trabeculoplasty (DSLT) on eyes with primary open angle glaucoma (POAG) and on primary angle closure glaucoma (PACG) eyes at 1 year follow up.

Università degli Studi della Campania Luigi Vanvitelli, Napoli, Italy.

In this study, 96 patients affected by POAG (77) or PACG (29) undergoing DSLT were enrolled, for a total of 185 eyes. Before each treatment and at each follow-up visit, all subjects underwent a complete eye visit, including the collection of data regarding the number and type of topical medications prescribed for glaucoma. The patients treated underwent 30-2 standardized automated perimetries (SAP) prior to DSLT, at 6 months and 12 monthspost DSLT procedure. Each patient was checked at 1 week and subsequently at 1, 3, 6 and 12 months. 

At 1 month follow up, both the eyes affected by POAG and those affected by PACG showed significantly (p<0.01) lower mean IOP (-4.61 ± 2.51 mmHg and -3.04 ± 2.12 mmHg, respectively) and lower mean number of IOP lowering topical drugs taken (-0.71 ± 0.49 and -0.73 ± 0.56, respectively) after DSLT. These reductions remained significant until the 1 year follow up, both for IOP (-4.23 ± 2.57 mmHg and -3.14 ± 2.38 mmHg respectively) and for drugs assumed (-0.74 ± 0.43 and 0.94 ± 0.48 respectively). The MD mean values showed perimetry stability both in POAG and in PACG eyes at 1 year follow up. No major complications were observed in the eyes included in this study.

Although this study has some limitations such as the retrospective design, the lack of comparison with standard selective laser trabeculopasty (SLT) and the relatively short follow up, thus the results observed require confirmation through further ones, with extended follow up and larger cohorts, this study suggests that DSLT would be a useful tool for the management of glaucoma patients.