Long term effects on the lowering of intraocular pressure: selective laser or argon laser trabeculoplasty?

Bovell, A.M.; Damji, Karim F.; Hodge, William; Rock, W.; Buhrmann, Ralf; Pan, Yi

doi:10.1016/j.jcjo.2011.07.016

Cited by 75 publications

(79 citation statements)

References 5 publications

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“…24 Data were available for 142 eyes at 3 years, 134 eyes at 4 years, and 120 eyes at 5 years. Lowering of IOP was similar at 3 years (SLT À 6.7 ± 7.1 vs ALT À 6.1±5.1 mm Hg); 4 years (SLT 7.0±7.7 vs ALT À 6.3±5.0 mm Hg); and 5 years (SLT À 7.4±7.3 vs ALT À 6.7±6.6 mm Hg).…”

Section: Slt Vs Altmentioning

confidence: 99%

Selective laser trabeculoplasty (SLT) vs other treatment modalities for glaucoma: systematic review

McAlinden

2013

Eye

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Purpose Systemic review to compare selective laser trabeculoplasty (SLT) to other glaucoma treatment options in terms of their intraocular pressure (IOP)-lowering effect. Methods Searches of the following databases were performed: PubMed, Cochrane Central Register of Controlled Trials, Ovid, EMBASE, metaRegister of Controlled Trials, and ClinicalTrials.gov. Only randomised controlled trials (RCTs) published in peer-reviewed journals comparing SLT to other glaucoma treatment options were considered. The main outcome measure was the change in IOP from baseline. Results An initial search of PubMed identified 23 RCTs with 17 meeting the inclusion criteria. Nine RCTs compared 1801 SLT to 1801 argon laser trabeculoplasty (ALT) and one trial compared 3601 SLT to 3601 ALT, all reporting no difference in terms of IOP reduction from baseline. One RCT reported better outcomes with SLT at 1 year but this effect regressed at 2 years. Three trials compared 3601 SLT to medical therapy and found no difference between the two treatment options. One trial found greater IOP reduction with latanoprost vs 901 and 1801 SLT, and greater IOP reduction with 1801 and 3601 SLT versus 901 SLT, however no differences were found between 3601 SLT versus latanoprost or 3601 vs 1801 SLT. Two trials compared 1801 SLT to 3601 SLT finding no difference in IOP reduction. Two trials compared 1801 SLT to 901 SLT, one finding no significant difference and one finding greater IOP reduction with 1801 SLT over 901 SLT. One trial compared excimer laser trabeculotomy (ELT) to 1801 SLT, finding no differences in IOP reduction up to 3 months follow-up but greater IOP reduction with ELT at time intervals between 9 and 24 months. There were no RCTs identified that compared SLT to surgery. Conclusion In terms of the IOP lowering effect, there is no difference between SLT and ALT. Three trials indicate no difference between 3601 SLT and medical therapy, with one of the trials indicating greater IOP reduction with latanoprost over 901 and 1801 SLT. Three trials indicate no difference between 1801 SLT and 3601 SLT. It is inconclusive whether 901 is less efficacious than 1801 SLT. One trial reports greater IOP reduction with ELT over 1801 SLT in the long term.

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Section: Slt Vs Altmentioning

confidence: 99%

Selective laser trabeculoplasty (SLT) vs other treatment modalities for glaucoma: systematic review

McAlinden

2013

Eye

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“…The treatment uses a 532-nm frequency-doubled q-switched neodymium: Ttrium-aluminum-garnet laser to selectively target pigmented trabecular meshwork cells 1. Trials comparing SLT to argon laser trabeculoplasty (ALT) have shown that both laser platforms produce comparable intraocular pressure (IOP) reductions 2345. Although multiple theories exist, the exact mechanism by which laser trabeculoplasty (ALT or SLT) lowers IOP remains unknown 67.…”

Section: Introductionmentioning

confidence: 99%

Repeat selective laser trabeculoplasty can be effective in eyes with initial modest response

Khouri

Lin

Berezina

et al. 2014

Middle East Afr J Ophthalmol

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Purpose:To evaluate the effectiveness of repeat selective laser trabeculoplasty (SLT) in eyes exhibiting only a modest response upon initial treatment.Materials and Methods:Retrospective chart review was conducted of 51 eyes that received initial 360 degree SLT (SLT1) and subsequent SLT (SLT2) from 2003-2011 at a large academic ophthalmology practice. Successful response (S) was a post-treatment 12 month mean IOP reduction ≥20% from baseline, while modest response (M) was <20% reduction over the same time. Chi-squared and log rank analyses were used to determine if success after SLT2 depended on having successful (S1) or modest (M1) response after SLT1.Results:IOP was significantly reduced from baseline in both SLT1 and SLT2. The proportion of eyes with S2 was not significantly different between those with initial M1 or S1 (36.67% vs. 52.38%, respectively; P = 0.26). Log rank analysis revealed no differences between M1 and S1 in determining SLT2 success (P = 0.41). This outcome was similar when the analyses were performed for the right and left eye independently.Conclusion:The proportion of eyes that successfully responded to repeat SLT did not differ based upon whether the response to initial SLT was successful or modest. This raises the possibility that repeat SLT should not be excluded as an option for those eyes that have only a modest initial response.

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“…Several retrospective and prospective studies comparing the clinical effectiveness of ALT with SLT showed no demonstrable short-term or long-term difference between the two modalities [23,[66][67][68][69][70]. Although IOP reduction is comparable, the true advantage of SLT over ALT lies in its superior safety profile and repeatability.…”

Section: Selective Laser Trabeculoplasty As Initial Treatmentmentioning

confidence: 99%

Laser Trabeculoplasty and Aqueous Dynamics

Lee¹,

Rahmatnejad²,

Waisbourd³

et al. 2016

Glaucoma - Intraocular Pressure and Aqueous Dynamics

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For the past four decades, laser trabeculoplasty has been a staple in the treatment armamentarium against glaucoma. Although the exact mechanism of laser trabeculoplasty has not been fully elucidated, its clinical utility in lowering intraocular pressure has been well established. Aqueous dynamic studies uniformly reveal an increase in aqueous outflow facility at the trabecular meshwork. Accumulating evidence suggests that the mechanism is the result of complex cellular and biochemical processes. Histopathological studies of the trabecular meshwork tissue after argon laser suggest an additional mechanical role. The traditional treatment algorithm for glaucoma placed laser trabeculoplasty as an intermediary between medical therapy and incisional surgery. However, because of the safety profile of selective laser trabeculoplasty, recent studies have challenged this treatment paradigm. One such study was a multicenter trial headed by our department that compared laser trabeculoplasty and medical therapy as initial treatment for glaucoma. We showed a similar efficacy between the two modalities, reinforcing the possibility of using laser as the initial treatment in the right clinical setting.

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Long term effects on the lowering of intraocular pressure: selective laser or argon laser trabeculoplasty?

Cited by 75 publications

References 5 publications

Selective laser trabeculoplasty (SLT) vs other treatment modalities for glaucoma: systematic review

Selective laser trabeculoplasty (SLT) vs other treatment modalities for glaucoma: systematic review

Repeat selective laser trabeculoplasty can be effective in eyes with initial modest response

Laser Trabeculoplasty and Aqueous Dynamics

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