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PURPOSE: To describe the 8-year results of excimer laser trabeculostomy (ELT) alone and ELT in conjunction with phacoemulsification (phaco). SETTING: University Hospital. DESIGN: Retrospective review. METHODS: 308 nm excimer laser energy delivered via an intraocular fiberoptic probe created channels through the inner wall of Schlemm's canal. Two groups were studied: ELT Alone and ELT + Phaco. Patients were adults with open-angle glaucoma or ocular hypertension on one or more intraocular pressure (IOP) lowering medications and, in the Phaco + ELT group, visually significant cataract. Primary outcome measures: Change of IOP from baseline and number of IOP lowering medications. RESULTS: 164 eyes in two groups, ELT Alone (n=90) and ELT + Phaco (n=74) were followed for 8 years. Baseline IOP in the ELT Alone group was 22.17 ± 7.0 mmHg and in the ELT+ Phaco group 21.9±6.44 mmHg. IOP in ELT Alone decreased to 16.84±5.2 mmHg at 1 year (n=69) and remained at 15.9±3.5 (n=19) at 8 years. IOP in ELT+ Phaco was 14.04±4.1 mmHg at 1 year (n=63) and 13.7±2.8 mmHg at 8 years (n=13). IOP lowering medications at baseline in ELT alone were 1.85±0.8 and decreased to 1.19±1.10 at 1 year and 1.4±1.4 at 8 years. In ELT + Phaco at baseline 1.58±0.8 and decreased to 0.97 ± 0.95 at 1 year and 1.85±0.7 at 8 years. CONCLUSIONS: ELT demonstrates long-term IOP lowering and decrease in IOP lowering medications. Benefits of this laser based implant-free MIGS procedure include a high safety profile and long-term efficacy.
UCLA Stein Eye Institute, Los Angeles, CA Glaucoma Institute of Beverly Hills, Beverly Hills, CA Ostwestfalen-Lippe (OWL) Eye Clinic in Detmold, Germany Vanderbilt University Medical Center, Department of Ophthalmology, Nashville, TN.
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