Selective Laser Trabeculoplasty – New Possibilities in Glaucoma Treatment
Authors:
P. Výborný; S. Sičáková
Authors‘ workplace:
Oční klinika 1. lékařské fakulty Univerzity Karlovy a Ústřední vojenské nemocnice, Praha
přednosta doc. MUDr. Jiří Pašta, CSc.
Published in:
Čes. a slov. Oftal., 65, 2009, No. 1, p. 8-11
Overview
The authors introduced into the clinical practice their own modification of the treatment by means of selective laser trabeculoplasty (SLT) in glaucoma patients. The SLT spots are burn in the extent of 270° circumferentially in the anterior chamber angle (1.0 mJ, 80 spots, 400 μm).
In the first group of 569 eyes with primary open angle glaucoma (POAG), followed up retrospectively and irregularly, at the control visit one year after the treatment, it was in 357 eyes possible, due to favorable decrease of the intraocular pressure (IOP), to decrease the medication from combined therapy to monotherapy, or to decrease the frequency of the application of antiglaucomatics, or to decrease their concentration. In other 197 eyes, the IOP was stabilized, but it was not possible to change the therapy, and in 15 cases, due to dissatisfactory effect of the treatment, the trabeculectomy was necessary.
In the second group of POAG patients (133 eyes) followed up prospectively 1, 3, 6 and 12 months after the treatment, the decrease of the IOP from 21.1 ± 4.5 mm Hg to 17.8 ± 3.2 mm Hg after one month (P < 0.0001), to 18.6 ± 3.6 mm Hg after 3 months, to 17.8 ± 3.1 mm Hg after 6 moths, and to 17.7 ± 2.8 mm Hg after 12 moths was established. Good effect to the decrease the IOP was proved in pseudoexfoliative glaucoma as well. In the pigmentary glaucoma, the decrease of the IOP was found to be temporary, and on the contrary, in two cases, shortly after the SLT, considerable elevation of the IOP was found with the necessity to perform the trabeculectomy.
The SLT may be used as the primary treatment in newly diagnosed POAG with advance, as well as possibility to terminate the treatment in cases when the glaucoma diagnosis is dubious.
Key words:
selective laser trabeculoplasty (SLT), glaucoma, intraocular pressure
Sources
1. Acott, T.S., Symplex, J.R, Bradley, J.M et al.: Trabecular repopulation by anterior trabecular meshwork cells after laser trabeculoplasty. Am. J. Ophthalmol., 107, 1989: 1–6.
2. Alvarado, J.A., Alvarado, R.G., Yeh, R.F. et al.: A new insight into the cellular regulation of aqueous outflow: how trabecular meshwork endothelial cells drive a mechanism that regulates the permeability of Schlemm’s canal endothelial cells. Br. J. Ophthalmol., 89, 2005: 1500–1505.
3. Best, U.P., Domack, H., Schmidt, V.: Long-term results after selective laser trabeculoplasty – a clinical study on 269 eyes [in German]. Klin. Monatsbl. Augenheilkd., 222, 2005: 326–331.
4. Best, U.P., Domack, H., Schmidt, V.: Pressure reduction after selective laser trabeculoplasty with two different laser systems and after argon laser trabeculoplasty – a controlled prospective clinical trial on 284 eyes [in German]. Klin. Monatsbl. Augenheilkd., 224, 2007: 173–179.
5. Bojič, L., Ivanisevič, M., Mandič, Z.: Argon laser trabeculoplasty or selective laser trabeculoplasty in the treatment of open-angle glaucoma [in Croatian]. Acta. Med. Croatica, 60, 2006: 97–99.
6. Bradley, J.M., Anderssohn, A.M., Colvis, C.M. et al.: Medication of laser trabeculoplasty – induced matrix metalloproteinase expression by IL-1 beta and TNF alpha. Invest. Ophthalmol. Vis. Sci., 41, 2000: 422–430.
7. Buys, Y.M.: Economics of selective laser trabeculoplasty as primary therapy for glaucoma. Can. J. Ophthalmol., 41, 2006: 419–420.
8. Chandrasekaran, S., Cumming, R.G., Rochtchina, E. et al.: Associations between elevated intraocular pressure and glaucoma, use of glaucoma medications, and 5-year incident cataract: the Blue Mountains Eye Study. Ophthalmology, 113, 2006: 417–424.
9. Chen, E., Golchin, S., Blomdahl, S.: A comparison between 90 degrees and 180 degrees selective laser trabeculoplasty. J. Glaucoma, 13, 2004: 62–65.
10. Cioffi, G.A., Latina, M.A., Schwartz, G.F.: Argon versus selective laser trabeculoplasty. J. Glaucoma, 13, 2004: 174–177.
11. Cvenkel, B.: One-year follow-up of selective laser trabeculoplasty in open-angle glaucoma. Ophthalmologica, 218, 2004: 20–25.
12. Damji, K.F., Bovell, A.M., Hodge, W.G. et al.: Selective laser trabeculoplasty versus argon laser trabeculoplasty: results from a 1-year randomised clinical trial. Br. J. Ophthalmol., 90, 2006: 1490–1494.
13. Francis, B.A., Lanchulev, T., Schofield, J.K. et al.: Selective laser trabeculoplasty as a replacement for medical therapy in open-angle glaucoma. Am. J. Ophthalmol., 140, 2005: 524–525.
14. Girkin, C.A.: Selective vs argon trabeculoplasty: controversy in evolution. Am. J. Ophthalmol., 144, 2007: 120–121.
15. Gracner, T.: Intraocular pressure reduction after selective laser trabeculoplasty in primary open angle glaucoma. Coll. Antropol., 25 (Suppl.), 2001: 111–115.
16. Gracner, T., Falez, M., Gracner, B. et al.: Long-term follow-up of selective laser trabeculoplasty in primary open-angle glaucoma [in German]. Klin. Monatsbl. Augenheilkd., 223, 2006: 743–747.
17. Gracner, T., Pahor, D., Gracner, B.: Efficacy of selective laser trabeculoplasty in the treatment of primary open-angle glaucoma [in German]. Klin. Monatsbl. Augenheilkd., 220, 2003: 848–852.
18. Hodge, W.G., Damji, K.F., Rock, W. et al.: Baseline IOP predicts selective laser trabeculoplasty success at 1 year post-treatment: results from a randomised clinical trial. Br. J. Ophthalmol. 89, 2005: 1157–1160.
19. Johnson, P.B., Katz, L.J., Rhee, D.J.: Selective laser trabeculoplasty: predictive value of early intraocular pressure measurements for success at 3 months. Br. J. Ophthalmol. 90, 2006: 741–743.
20. Juzych, M.S., Chopra, V., Banitt, M.R. et al.: Comparison of long-term outcomes of selective laser trabeculoplasty versus argon laser trabeculoplasty in open-angle glaucoma. Ophthalmology, 111, 2004: 1853–1859.
21. Lanzetta, P., Menchini, U., Virgili, G.: Immediate intraocular pressure response to selective laser trabeculoplasty. Br. J. Ophthalmol., 83, 1999: 29–32.
22. Latina, M.A., Park, C.: Selective targeting of trabecular meshwork cells: in vitro studies of pulsed and CW laser interactions. Exp. Eye Res., 60, 1995: 359–371.
23. Latina, M.A.: Selective laser trabeculoplasty –180 – degree treatment. J. Glaucoma.16, 2007: 274–275.
24. Latina, M.A., Sibayan, S.A., Shin, D.H. et al.: Q-switched 532-nm Nd:YAG laser trabeculoplasty (selective laser trabeculopasty): a multicenter, pilot, clinical study. Ophthalmology, 105, 1998: 2082–2090.
25. Latina, M.A., de Leon, J.M: Selective laser trabeculoplasty. Ophthalmol. Clin. North. Am., 18, 2005: 409–419.
26. Lee, R., Hutnik, C.M.: Projected cost comparison of selective laser trabeculoplasty versus glaucoma medication in the Ontario Health Insurance Plan. Can. J. Ophthalmol., 41, 2006: 449–456.
27. Lee, P.P., Kelly, S.P., Mills, R.P. et al.: Glaucoma in the United States and Europe: predicting costs and surgical rates based upon stage of disease. J. Glaucom, 16, 2007: 471–478
28. Lee, P.P., Walt, J.G., Doyle, J.J. et al.: A multicenter, retrospective pilot study of resource use and costs associated with severity of disease in glaucoma. Arch. Ophthalmol., 124, 2006: 12–19.
29. Lefrancois, A.: What should we think? Is selective trabeculoplasty more effective than conventional argon laser trabeculoplasty [in French]? J. Fr. Ophthalmol., 30, 2007: 3S74–3S78.
30. Melamed, S., Ben Simon, G.J., Levkovitch-Verbin, H.: Selective laser trabeculoplasty as primary treatment for open-angle glaucoma: a prospective, nonrandomized pilot study. Arch. Ophthalmol., 121, 2003: 957–960
31. Melamed, S., Pei, J., Epstein, D.L.: Short-term effect of argon laser trabeculoplasty in monkeys. Arch. Ophthalmol., 103, 1985: 1546–1552
32. Melamed, S., Pei, J., Epstein, D.L.: Delayed response to argon laser trabeculoplasty in monkeys. Morphological and morphometric analysis. Arch. Ophthalmol., 104, 1986: 1078–1083
33. Nagar, M., Ogunyomade, A., Brart, D.P. et al.: A randomized, prospective study comparing selective laser trabeculoplasty with latanoprost for the control of intraocular pressure in ocular hypertension and open angle glaucoma. Br. J. Ophthalmol., 89, 2005: 1413–1417.
34. Pizzimenti, J.J., Nickerson, M.M., Pizzimenti, C.E. et al: Selective laser trabeculoplasty for intraocular pressure elevation after intravitreal triamcinolone acetonide injection. Optom. Vis. Sci., 83, 2006: 421–425.
35. Qian, S.H., Sun, X.H: Selective laser trabeculoplasty in the treatment of primary open-angle glaucoma [in Chinese]. Zhonghua Yi Xue Za Zhi., 87, 2007: 118–120.
36. Rachmiel, R., Trope, G.E., Chipman, M.L. et al.: Laser trabeculoplasty trends with the introduction of new medical treatments and selective laser trabeculoplasty. J. Glaucoma, 15, 2006: 306–309.
37. Rozsíval, P., Kaňa, V., Hovorková, M.: Selektivní laserová trabekuloplastika. Čes. a slov. Oftal., 60, 2004: 267–274.
38. Stein, J.D., Challa, P.: Mechanisms of action and efficacy of argon laser trabeculoplasty and selective laser trabeculoplasty. Curr. Opin. Ophthalmol., 18, 2007: 140–145.
39. Vaidergorn, P.G., Susanna, R. Jr.: Argon laser trabeculoplasty and reduction of ocular hypotensive medication used by glaucoma patients. Can. J. Ophthalmol., 41, 2006: 44–50.
40. Van de Veire, S., Zeyen, T., Stalmans, I.: Argon versus selective laser trabeculoplasty. Bull. Soc. Belge Ophtalmol., 299, 2006: 5–10.
41. Weinand, F.S., Althen, F.: Long-term clinical results of selective laser trabeculoplasty in the treatment of primary open angle glaucoma. Eur. J. Ophthalmol., 16, 2006: 100–104.
42. Yablonski, M.E., Cook, D.J., Gray, J.: A fluorophotometric study of the effect of argon laser trabeculoplasty on aqueous humor dynamics. Am. J. Ophthalmol., 99, 1985: 579–582.
Labels
OphthalmologyArticle was published in
Czech and Slovak Ophthalmology
2009 Issue 1
Most read in this issue
- Central Corneal Thickness, Intraocular Pressure and Their Correlation in Healthy Czech Children Aged 7–17 Years
- Selective Laser Trabeculoplasty – New Possibilities in Glaucoma Treatment
- The Follow up of Prognostic Important Factors and Analysis of Five Years Survival Rate in Patients with Uveal Melanoma at the Department of Ophthalmology, 3rd Medical Faculty, Charles University in Prague and the Faculty Hospital Královské Vinohrady in Prague
- Digital Images of the Retinal Nerve Fiber Layer in Healthy Eye and in Glaucoma