Selective Trabeculoplasty in the Management of Open Angle Glaucoma: Retrospective Analysis at 1 Year

Abstract

Purpose: The objective of this study was to observe the 1-year pressure gain in a consecutive series of glaucoma patients treated by selective laser trabeculoplasty, along with the clinical and technical characteristics that influence the evolution of intraocular pressure after treatment. Materials and methods:We carried out a retrospective study of all patients treated in the ophthalmology department of Nancy University Hospital between January 2015 and March 2016. Treatment was performed with a Q-Switched, frequency doubled Nd: YAG laser (Solutis -Quantel Medical, France), over 180° or 360° of the trabecular meshwork. The mean decreases in Intraocular pressure and the success rate (defined as a decrease in intraocular pressure of ≥ 20% at 1 year without increasing the medical treatment) were calculated. The impact of the different clinical and technical characteristics of each case on the decrease in pressure was also studied by bivariate analysis. Results:One hundred and nineteen eyes, in 78 patients, were included. The decrease in IOP at 1 year was in mean of 4.2 mmHg (Standard Deviation = 5.37), and of 19.6% from baseline. The success rate was 46.7%. Only two minor and reversible complications occurred during the follow-up period.Discussion: Selective trabeculoplasty is currently a therapeutic option called-upon at different stages in the progression of glaucoma. The duration of efficacy of this laser therapy, and the retreatment frequency are yet to be defined.

Suspected glaucoma: who is who?

“…Although it does not work the same in all patients and over time it loses its effect, it is a procedure that can be repeated more than once, maintaining few adverse effects, but the great advantage it has is that you do not have to worry about the compliance or possible drug toxicity and depending on the time the effect lasts, the economic factor will also be an advantage. 4,[28][29][30] In a patient with suspected angle closure, there are no studies that document the benefit of performing a preventive iridotomy, but against the risk of developing an acute condition due to angle closure, always evaluating and considering the risk that each patient has, not only due to the presence of narrow angles in the gonioscopic evaluation, if not the conditions that may lead to the appearance of a block, it is recommended to perform a preventive peripheral iridotomy. 17,31…”