Abstract

SO.14.04

Long-term effect of Selective Lasertrabeculoplasty (SLT) on intraocular pressure in ocular hypertensives and glaucoma

Karin Hornykewycz1, Christine Wintersteller2, Herbert Reitsamer2, Günter Grabner2, Wolfgang Hitzl2, Lutz E. Pillunat1
1Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Carl Gustav Carus, Dresden, 2Augenabteilung, Paracelsus Medizinische Privatuniversität, Salzburg, Österreich

Objective
Aim of the prospective, clinical study was to elucidate the long term effect of selective laser trabeculoplasty (SLT) on IOP and to analyze whether SLT treatment contributes to reach an individual target pressure.
Methods
201 eyes of 141 patients underwent SLT using a Q-switched ND: YAG laser (532 nm). 50 spots were applied inferiorly and in 28 cases (13,9%) another 50 spots in the upper trabecular meshwork with a total energy of 0.5 - 1,2 mJ/spot. Patients (mean age 62,7 years, 41,7% female, 58,3% male, 65 eyes suffering from ocular hypertension, 146 eyes with manifest glaucoma) underwent IOP measurements after 1 day, 4 weeks, 3 month, 6 month, and one time per year for a total follow-up time of 3 years (n=40).
Results
After 6 month a 20% IOP reduction was reached in 86 eyes (R) and in 63 eyes it was not reaches (NR), from 52 eyes results were missing (MD). A 30% IOP reduction was reached in 37 eyes and not reached in 112 eyes. An individual target pressure was reached in 107 eyes and not reached in 42 eyes. After a year the results were as follows: R (20%-30%-TP) = 83-38-97, NR = 46-91-32, MD = 72 and after 3 years R = 28-11-35, NR = 12-29-5, MD = 161. Mean IOP dropped significantly from 19.5 mmHg to 15,1 mmHg after 1 year. In 127 eyes medical treatment was reduced or abolished.
Conclusions
In most patients SLT showed a long-term effect of IOP lowering and contributed to reach an individual target pressure. The overall effect after one year seems to be comparable to a beta blocker treatment. Therefore SLT seems to represent a useful tool in long-term glaucoma therapy.

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