Selective laser trabeculoplasty for primary open-angle glaucoma patients younger than 40 years

Gupta, Viney; Ghosh, Sarbani; Sujeeth, M.; Chaudhary, Sunil; Gupta, Shikha; Chaurasia, Abadh K; Sihota, Ramanjit; Gupta, Amisha; Kapoor, Kulwant Singh

doi:10.1016/j.jcjo.2017.07.023

Cited by 13 publications

(7 citation statements)

References 31 publications

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“…The only significant parameter was the presence of goniodysgenesis. Eyes without goniodysgenesis had a 4.3-fold (95% CI 1.1–15.2) higher chance of appropriate IOP reduction compared with those affected by angle dysgenesis ( p = 0.034) [ 46 ].…”

Section: Efficacy Of Treatmentmentioning

confidence: 99%

“…In both studies, SLT proved to be effective in young patients with open-angle glaucoma. Since shortening the period of topical medication use or achieving independence from it is of particular value to younger patients, further randomized controlled trials need to be promptly conducted to provide a higher grade of evidence [ 46 , 47 ].…”

Section: Efficacy Of Treatmentmentioning

confidence: 99%

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Selective Laser Trabeculoplasty in the Treatment of Ocular Hypertension and Open-Angle Glaucoma: Clinical Review

Zgryźniak

Przeździecka-Dołyk

Szaliński

et al. 2021

JCM

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Selective laser trabeculoplasty (SLT) is a glaucoma treatment that reduces intraocular pressure (IOP). Its mechanism is based on the biological effects of the selective application of laser energy to pigmented trabecular meshwork (TM) cells, resulting in increased outflow facility. Herein, we review current publications on SLT and summarize its efficacy and safety for different indications in open-angle glaucoma (OAG) and ocular hypertension (OHT) treatment. SLT effectively reduces IOP when used as a primary treatment. In patients whose IOP is medically controlled, SLT helps to reduce medication use, and when maximally tolerated topical therapy is ineffective, SLT facilitates the realization of the target IOP. SLT is a repeatable procedure for which the vast majority of complications are mild and self-limiting. With effective IOP reduction, low complication rates and the potential to repeat the procedure, SLT offers the possibility of delaying the introduction of medical therapy and other more invasive treatment modalities while simultaneously avoiding the accompanying complications. With this knowledge, we suggest that SLT be considered as an essential primary treatment option in OAG and OHT, switching to other treatment modalities only when laser procedures are insufficient for achieving the required target IOP.

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Section: Efficacy Of Treatmentmentioning

confidence: 99%

Section: Efficacy Of Treatmentmentioning

confidence: 99%

Selective Laser Trabeculoplasty in the Treatment of Ocular Hypertension and Open-Angle Glaucoma: Clinical Review

Zgryźniak

Przeździecka-Dołyk

Szaliński

et al. 2021

JCM

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“…4 Although laser trabeculoplasty is recommended in this period but the results In the North Indian population are likely to lower IOP maximally by 4-5mm only. 5 The risk of rebound spike exists, and it may not be as effective in young patients and in cases due to angular alterations inherent to the disease. 6 Considering the younger age of patients and non-usage of antimetabolites, the risk of failure of trabeculectomy is high in pregnant women, yet it can provide an immediate control of IOP and help a critical patient reach a stage when medical or repeat surgical treatment is safe.…”

Section: Np50mentioning

confidence: 99%

Trabeculectomy in first trimester of pregnancy: A case report

Kumar

Singh

Taneja

2023

European Journal of Ophthalmology

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Purpose Glaucoma management in pregnancy is a challenging task for the ophthalmologist. With limited studies due to ethical concerns, the exact management protocols are not well established. Surgery has been mentioned as an option in 2nd trimester and is avoided in 1st trimester due to the detrimental effect on organogenesis of fetus and the harmful effects of anaesthesia. Methods A 26 year old woman with advanced glaucomatous damage underwent trabeculectomy without antifibrotic agent in first trimester of pregnancy. Results The intraocular pressures (IOP) were well controlled during pregnancy with no need of addiitional antiglaucoma medications. She delivered a healthy baby at term with no congenital abnormality. Conclusion Trabeculectomy without antifibrotic agents can be done in first trimester of pregnancy in cases where IOP cannot be controlled with topical antiglaucoma drugs that are considered safe during this period. This is the first report in literature on trabeculectomy in first trimester of pregnancy.

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“…Treatment with selective laser trabeculoplasty (SLT) may delay or reduce the need for surgery. Gupta et al [20] prospectively studied the efficacy of SLT in lowering IOP in 30 JOAG eyes. SLT significantly lowered IOP and eliminated the need for further medication or surgery in 43% of eyes at 12 months follow-up, suggesting that SLT may be an effective alternative to early surgical management.…”

Section: Key Pointsmentioning

confidence: 99%

Juvenile open angle glaucoma: current diagnosis and management

Ciociola¹,

Klifto

2021

Current Opinion in Ophthalmology

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Purpose of reviewThe aim of this article is to summarize up-to-date research on the diagnosis and management of juvenile open-angle glaucoma (JOAG). Recent findingsJOAG can be subclassified into four clinical phenotypes, and faster myopic shift is a risk factor for disease progression. Vessel density is associated with structural damage and worsening visual acuity in JOAG and can be monitored with optical coherence tomography angiography. Genetic studies have revealed molecular causes of JOAG including variants in CPAMD8, MYOC, and CYP1B1. Tube shunt surgeries as well as gonioscopy-assisted transluminal trabeculotomy have been shown to be successful in JOAG. SummaryAlthough genetic advances may improve future screening, intraocular pressure monitoring and fundoscopic exam remain the current mainstay of diagnosis. Medical treatment alone for JOAG is typically insufficient with patients requiring surgical management. Selective laser trabeculoplasty may delay or decrease the need for surgery. Trabeculectomy has traditionally been shown to be effective in JOAG, but tube shunt surgery and microinvasive glaucoma surgery are effective alternatives.

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Selective laser trabeculoplasty for primary open-angle glaucoma patients younger than 40 years

Abstract: A significant proportion of patients with JOAG can benefit from an IOP reduction after SLT. Those with gonioscopically normal-appearing angles are more likely to respond to SLT.

Cited by 13 publications

References 31 publications

Selective Laser Trabeculoplasty in the Treatment of Ocular Hypertension and Open-Angle Glaucoma: Clinical Review

Selective Laser Trabeculoplasty in the Treatment of Ocular Hypertension and Open-Angle Glaucoma: Clinical Review

Trabeculectomy in first trimester of pregnancy: A case report

Juvenile open angle glaucoma: current diagnosis and management

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