Objective: To investigate the safety and efficacy of Selective Laser
Trabeculotherapy (SLT) to reduce the intraocular pressure (IOP) in patients
with open angle glaucoma(OAG) whose
IOP could not be controlled by
maximal tolerated medical therapy or argon laser trabeculoplasty.
Design: Non-randomized, prospective, multi-center
trial.
Participants: One hundred twenty eyes of 120 patients with
uncontrolled OAG were treated with SLT. 101 patients completed the 26
week study of which 45 eyes were on maximum tolerated medications (Max Rx
group) and 56 eyes had previously failed argon laser trabeculoplasty (PFLT
group).
Intervention: Patients underwent SLT using a 532 nm
frequency doubled, Q-switched, Nd:YAG Laser with a 3 nsec pulse duration
and 400 um spot. A total of 50
spots were placed over 180 degrees
of the trabecular meshwork at energies of
0.4 to 1.4 mJ/ pulse.
Results: The mean IOP reduction at 26 weeks was 5.2 mmHg (20.3%) for the Max Rx group, 3.8 mmHg (14.7 %)
for the PFLT group, and 4.4 mmHg (17.2%) for both groups combined. Thirty four
of the 45 patients (75.6%) in the Max Rx group, and 37 of the 56 patients
(66.1%) in the PFLT group responded to treatment with an IOP reduction of at
least 3 mmHg up to 26th week after SLT. No serious adverse events were observed.
Conclusion: SLT appears to be a safe and effective treatment modality for lowering intraocular pressure in
patients with uncontrolled OAG who are either on MTMT or had previously
undergone a failed argon laser trabeculoplasty.