Corneal Endothelial Abnormalities After Selective Laser Trabeculoplasty (SLT)

Abstract

The corneal endothelial abnormalities after SLT shown in this study may be transient, and long-term effects are probably negligible in normal corneas or single treatments. However, in corneas with reduced transparency of the endothelium, such as compromised corneas and corneas with pigment deposits on the endothelium, there may be a risk of further corneal endothelial compromise, especially after repeated SLT. Larger and longer term studies with histopathologic evaluation would be useful to evaluate the effect of SLT on normal and subnormal corneal endothelium. Until further studies are done, it would be wise to minimize the number and energy of SLT laser shots.

Acute corneal edema with subsequent thinning and hyperopic shift following selective laser trabeculoplasty

“…15–17 In extreme cases, these changes could result in endothelial dysfunction and subsequent edema following SLT. However, none of our 4 patients was found to have endothelial pigment prior to treatment.…”

Significant peripheral anterior synechiae after repeat selectıve laser trabeculoplasty

“…In addition, SLT can cause keratopathy via unknown Correspondence mechanisms, and perhaps this can lead to PAS in some patients. 12,13 However, we do not think that PAS developed because of keratopathy in our patients, because they had uneventful postoperative course regarding anterior chamber reaction, corneal findings, and IOP. Also, specular microscopy findings did not display significant differences between the eyes with PAS and the fellow eyes.…”

Intraocular Pressure Spike and Corneal Decompensation Following Selective Laser Trabeculoplasty in Patients With Exfoliation Glaucoma

“…The patients demonstrating the most of these spots had the lowest endothelial cell counts, although this did not reach statistical significance. 21 Further study is warranted regarding this possible connection between SLT and transient endothelial cell loss. If confirmed, this may represent a potential link between SLT and the reported cases of corneal edema.…”