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Abstract #70225 Published in IGR 18-2
Transscleral Selective Laser Trabeculoplasty Without a Gonioscopy Lens
Geffen N; Ofir S; Belkin A; Segev F; Barkana Y; Kaplan Messas A; Assia EI; Belkin MJournal of Glaucoma 2017; 26: 201-207
PURPOSE OF THE STUDY: The purpose of the study was to investigate results of selective laser trabeculoplasty (SLT) performed directly on the sclera without a gonioscopy lens. DESIGN: Interventional case series, prospective, randomized, masked, controlled clinical trial. METHODS: Setting: Meir Medical Center, Kfar-Saba, Israel. STUDY POPULATION: Adults with uncontrolled primary open angle or pseudoexfoliation glaucoma randomized into 2 groups. INTERVENTION: The controls underwent conventional SLT with 100 spots delivered using a gonioscopy lens for 360 degrees of the trabecular meshwork. The study group underwent irradiation using the same parameters with the laser applications administered on the perilimbal sclera. Study visits: 1 hour, 1, 7, 30, 60, 180, and 365 days postprocedure. MAIN OUTCOME MEASURES: Intraocular pressure (IOP) and side effects. RESULTS: Thirty adults were randomized into 2 groups. The mean (±SD) pretreatment IOP was 20.21±3.19 mm Hg for the study group (n=14) and 21.14±2.98 mm Hg for the controls (n=14; P =0.43), dropping to 15.50±3.77 and 15.00±4.08 mm Hg (P =0.74) after 6 months and to 16.00±3.31 and 14.00±2.45 mm Hg (P =0.22) after 12 months. The average IOP reduction after 6 and 12 months was 23.4% and 20.83% for the study group and 27.1% and 33.77% for the controls (P=0.528). Success (a decrease of ≥15% at 6 months with no additional medications, laser, or glaucoma surgery) was achieved in 12 (85.7%) study patients and 9 (69.2%) controls (P=0.385). Complications were mild and transient (n=30), although significantly higher in the controls (n=15; P <0.0001). CONCLUSIONS: SLT applied directly to the perilimbal sclera may be as efficacious as the conventional procedure for 1 year.
*Department of Ophthalmology, Meir Medical Center, Kfar Saba §Department of Ophthalmology, Assaf Harofeh Medical Center †Sackler Faculty of Medicine, Tel Aviv University ‡The Ein Tal Medical Center, Tel-Aviv ∥Department of Ophthalmology, Goldschleger Eye Research Institute, Sheba Medical Center, Tel Hashomer, Israel.
Full articleClassification:
12.4 Laser trabeculoplasty and other laser treatment of the angle (Part of: 12 Surgical treatment)
