A Game-Changer For Glaucoma Management In Severe Cicatricial Conjunctivitis
Published 2025 - 43rd Congress of the ESCRS
Reference: PO963 | Type: Poster | DOI: 10.82333/zj4e-nz67
Authors: Chiara Bonzano* 1 , Carlo Alberto Cutolo 1 , Laura Calabrese 1 , Carlo Enrico Traverso 1 , Michele Iester 1
1Clinica Oculistica,Genoa,Italy
Purpose
To evaluate the efficacy of Selective Laser Trabeculoplasty (SLT) in lowering intraocular pressure (IOP) while preserving ocular surface integrity in patients with glaucoma and severe cicatricial conjunctivitis (CC). Given the challenges posed by topical antiglaucoma therapy in these patients, SLT may represent a valuable alternative to reduce medication burden and delay surgical interventions.
Setting
This study was conducted at the Clinica Oculistica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy, involving patients with glaucoma and severe ocular surface disease who underwent SLT.
Methods
Patients with glaucoma and severe ocular surface disease underwent SLT. Baseline assessments (two weeks before treatment) and follow-ups at 2 weeks, 1, 3, 6, and 12 months included Goldmann applanation tonometry, Schirmer test, Tear Break-Up Time (TBUT), corneal fluorescein staining, and Ocular Surface Disease Index (OSDI). Systemic immunosuppressive therapy was maintained throughout the study.
Results
Ten eyes from seven patients (6 females, 1 male; mean age 58.8 ± 14.2 years) were included. Diagnoses included Ocular Graft-versus-Host Disease (n=2), Systemic Sclerosis (n=1), Ocular Cicatricial Pemphigoid (n=3), and Stevens-Johnson Syndrome (n=1). Mean IOP significantly decreased from 23.8 ± 2.1 mmHg to 15.9 ± 1.8 mmHg at 12 months (p < 0.001), while the number of IOP-lowering medications was reduced from 2.2 ± 0.8 to 0.7 ± 0.7 (p < 0.001). OSDI scores improved in 70% of cases, TBUT increased in 80% of eyes, and corneal staining decreased at 6 and 12 months. ST values remained stable. One eye required repeat SLT, and one underwent filtration surgery.
Conclusions
SLT is an effective option for reducing IOP while preserving the ocular surface, minimizing reliance on topical therapy, and potentially delaying invasive procedures. Its safety profile and therapeutic benefits make it a valuable approach for glaucoma patients with severe ocular surface disease, where surgical interventions are particularly challenging.