Selective laser trabeculoplasty as secondary therapy in patients with glaucoma five year experience
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SELECTIVE LASER TRABECULOPLASTY AS SECONDARY THERAPY IN PATIENTS WITH GLAUCOMA: FIVE-YEAR EXPERIENCE. Arusha Gupta, MD Elaine M. Miglino Lawrence F. Jindra, MD. Financial Disclosures. 1 st and 2 nd authors have no financial disclosure.

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Selective laser trabeculoplasty as secondary therapy in patients with glaucoma five year experience

SELECTIVE LASER TRABECULOPLASTY AS SECONDARY THERAPY IN PATIENTS WITH GLAUCOMA: FIVE-YEAR EXPERIENCE

Arusha Gupta, MD

Elaine M. Miglino

Lawrence F. Jindra, MD


Financial disclosures
Financial Disclosures PATIENTS WITH GLAUCOMA: FIVE-YEAR EXPERIENCE

1st and 2nd authors have no financial disclosure.

3rd author has independently conducted and financed clinical research study presented and provides technical advice and consultant services to Lumenis Corporation.


Introduction
Introduction PATIENTS WITH GLAUCOMA: FIVE-YEAR EXPERIENCE

Selective Laser Trabeculoplasty (SLT) uses a Q-Switched frequency-doubled (532 nm) Nd:YAG laser which targets melanocytes in the pigmented trabecular meshwork.1,2 When treated with SLT, a primarily biologic response is induced in the trabecular meshwork which involves the release of cytokines that trigger macrophage recruitment and other changes leading to IOP reduction.2It treats the meshwork without causing any thermal or coagulative damage to surrounding structures.1,2

1. Latina MA, et al. Selective targeting of trabecular meshwork cells: in vitro studies of pulsed and cw laser interactions. Exp Eye Res. 1995;60:359-372. 2. Latina MA, et al. Q-switched 532-nm Nd:YAG laser trabeculoplasty (selective laser trabeculoplasty): a multicenter, pilot, clinical study. Ophthalmology. 1998;105:2082-2090.


Objective and methods
Objective and Methods PATIENTS WITH GLAUCOMA: FIVE-YEAR EXPERIENCE

To evaluate SLT as secondary therapy (eyes treated with medications) in decreasing intraocular pressure (IOP) and in reducing usage of glaucoma medication (meds) in patients with glaucoma.

A retrospective chart review was performed on 756 of 2056 eyes in a consecutive case series from patients treated with SLT as secondary therapy over 5 years between 2002 and 2007.Two-tailed paired t-test was used to compare maximum pre- and post-SLT IOP and pre- and post-SLT number of meds.


Results iop
Results: IOP PATIENTS WITH GLAUCOMA: FIVE-YEAR EXPERIENCE

756 eyes received SLT as secondary treatment for glaucoma; mean follow-up time was 362 days.

IOP decreased from a mean of 20.0 mm Hg ± 6.0 to 15.8 mm Hg ±4.9. This represents a 21% decrease in IOP or 4.2 mm Hg.

Data were significant with P < 0.01.


Results meds
Results: Meds PATIENTS WITH GLAUCOMA: FIVE-YEAR EXPERIENCE

Mean number of meds decreased from 2.3 to 1.3 meds; this represents a 43%decrease in meds used.

Success rate (no meds needed post-SLT) was 42% of eyes treated.

Data were significant with P < 0.01.


Data iop
Data: IOP PATIENTS WITH GLAUCOMA: FIVE-YEAR EXPERIENCE


Data meds
Data: Meds PATIENTS WITH GLAUCOMA: FIVE-YEAR EXPERIENCE


Results iop meds
Results: IOP & Meds PATIENTS WITH GLAUCOMA: FIVE-YEAR EXPERIENCE


Summary
Summary PATIENTS WITH GLAUCOMA: FIVE-YEAR EXPERIENCE

Mean Post-SLT reduction in:

IOP 21%

Meds 43%

The results were significant with P < 0.01.


Conclusion
Conclusion PATIENTS WITH GLAUCOMA: FIVE-YEAR EXPERIENCE

In this clinical series, SLT significantly lowered intraocular pressure and the amount of medications required,when used as secondary treatment for glaucoma.


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