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PURPOSE: To determine long-term efficacy of selective Laser Trabeculoplasty (SLT) over 12 years in chronic open-angle glaucoma (OAG) patients. METHODS: In this retrospective study, all patients treated by SLT between 1997 and 1999 for OAG were included and followed up every 6 months. The procedure was performed with a Coherent Selecta 7000 Nd:YAG with 100±10 non overlapping 400μm spots over 360 degrees centered on the trabecular meshwork. Patients were excluded in the case of prior filtration surgery or Argon laser trabeculoplasty. Our primary study parameter was the number of patients requiring filtration surgery within the follow-up period. Our secondary parameters were intraocular pressure (IOP) and SLT-related complications. RESULTS: We included 46 eyes of 28 patients. The 12-year success rate was 26.1%. Thirty-nine percent of all eyes underwent filtration surgery (failure) during the follow-up period, and 34.8% were lost to follow-up. In the pigmentary glaucoma (PG) subgroup, the 12-year success rate was 16%, while it was 37.5% in the Primary OAG subgroup. The overall mean IOP was 22.8mmHg (D.S. 3.78) prior to laser, 16.08mmHg (D.S. 2.7) at 1 year and 15mmHg (D.S. 1.8) at 12 years. The mean number of medications was 1.6 (D.S. 0.8) prior to SLT, 1.36 (D.S. 0.8) at 1 year, and 1.3 (D.S. 1.2), 12 years after SLT respectively. No patients had a second SLT treatment. No significant complications occurred during follow-up. CONCLUSION: Selective laser trabeculoplasty may at times be a useful resource to lower IOP in patients with OAG. Nonetheless, the failure rate is significant especially in PG, which requires confirmation by larger prospective studies.
Département d'ophtalmologie, hôpital Avicenne, université Paris XIII, 125, rue de Stalingrad, 93000 Bobigny, France. Electronic address: audreygiocanti@yahoo.fr.
Full article12.4 Laser trabeculoplasty and other laser treatment of the angle (Part of: 12 Surgical treatment)