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Abstract #52415 Published in IGR 15-1

Corneal endothelial changes after selective laser trabeculoplasty

Ong K; Ong L
Clinical and Experimental Ophthalmology 2013; 41: 537-540


BACKGROUND: Whitish spots are sometimes noted in the corneal endothelium after Selective Laser Trabeculoplasty (SLT). To evaluate the corneal endothelium after SLT, corneal specular microscopy was performed. DESIGN: Prospective observational study in a private practice. PARTICIPANTS: 15 consecutive patients with open angle glaucoma who had SLT in February 2012, had their corneal endothelium examined with specular microscopy before and after SLT. METHODS: SLT was done with 50+5 shots to 180 degrees of meshwork, using 0.3 to 0.9 mJ of power to achieve the reaction of a hint of microbubbles in 80% of laser shots. MAIN OUTCOME MEASURES: Corneal specular microscopy photographs (0.25 mm x 0.54 mm) were taken pre-SLT, immediately after SLT, and one month after SLT. These photographs were assessed for changes after SLT, and graded. RESULTS: Of the 15 patients, 3 showed numerous and 4 showed few dark spots after SLT. All the dark spots resolved by one month. 8 patients had no increase of dark spots after SLT. CONCLUSION: The effect of SLT on the corneal endothelium may be transient, and long term effects are probably negligible in normal corneas. However, in compromised corneas and corneas with pigment deposits on endothelium, there may be a risk of corneal endothelial compromise especially after repeated SLT. Larger and longer term studies with histopathologic evaluation would be useful to evaluate the effect of SLT on normal and subnormal corneal endothelium. Until further studies are done, it would be wise to minimise the number and energy of SLT laser shots.

University of Sydney, Australia; Royal North Shore & Ryde Hospital, Australia; Dalcross Adventist Hospital, Australia.

Full article

Classification:

12.4 Laser trabeculoplasty and other laser treatment of the angle (Part of: 12 Surgical treatment)
2.2 Cornea (Part of: 2 Anatomical structures in glaucoma)



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