SELECTIVE LASER TRABECULOPLASTY: A NEW TREATMENT FOR GLAUCOMA

F. Howes and M. Nagar 

Clayton Specialist Eye Centre, Pinderfields and Pontefract Hospitals NHS Trust, West Yorkshire, United Kingdom

PURPOSE

The purpose of our study is to investigate the safety and efficacy of intra-ocular pressure (IOP) reduction with Selective Laser Trabeculoplasty (SLT)

METHODS

62 patients (107 eyes) enrolled for this study. They had either medically uncontrolled primary open angle glaucoma, or medically uncontrolled ocular hypertension.  Selective laser trabeculoplasty was carried out using Coherent Selecta 7000, frequency doubled Nd:YAG laser.

After laser treatment patients were maintained on the identical antiglaucoma drug regimen as they were prior to SLT.  AC reaction, IOP’s, peripheral anterior synechiae, visual fields and subjective discomfort were observed posttreatment.

RESULTS

Both groups responded well to SLT showing similar IOP reduction over time (20%). 90% of patients showed 3mmHg or more drop in intra-ocular pressure (IOP) This drop is noted at day one with a subsequent rise over 7 days, with stability following at approximately 6 weeks. A subgroup of late responders (10% of patients) showed rise following treatment to pre-SLT levels with a late drop noted at 2 months (average). Transient IOP elevation is seen in 8 % of patients and anterior chamber activity in 12 % of patients. Peripheral Anterior Synechiae have not been seen in any of these patients.

CONCLUSION

SLT is a safe & effective procedure easy to perform with minimal discomfort to the patient. The results are seen immediately as the IOP drop is seen on day one following SLT.  The effect is sustained within the duration of trial to date (11 months).  There have been no long term clinical side effects noted.