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Abstract #6230 Published in IGR 2-2
Use of YAG-Selecta laser and argon laser in the treatment of open angle glaucoma
Popiela G; Muzyka M; Szelepin L; Cwirko M; Nizankowska MHKlinika Oczna 2000; 102: 129-133
INTRODUCTION: The falling success rate of argon laser trabeculoplasty (ALT) has raised the interest in some new laser techniques, such as q-switched Nd:YAG laser trabeculoplasty (Coherent Selecta 7000). The 'selective' laser trabeculoplasty destroys melanosomes of pigmented trabecular meshwork cells, sparing adjacent non-pigmented cells and tissues. AIM: The goal was to establish the IOP lowering effect of selective laser trabeculoplasty (SLT) compared to ALT. MATERIAL AND METHODS: The authors examined 27 patients (ten males, 17 females) aged 35-82 years, with open-angle glaucoma and visual field deterioration despite maximal tolerated topical therapy (21 patients, POAG; three, NPG; one, pigmentary glaucoma; one, pseudoexfoliative glaucoma; one, juvenile glaucoma). One eye of each patient was randomly chosen for SLT, the other underwent ALT. With each method, 50 burns were applied at a 180° angle with power settings of 600-1000 mW for ALT and energy settings of 0.5-1.4 mJ for SLT. The IOP was measured one hour before laser treatment and one, two, and 24 hours, and three months after treatment. RESULTS: The mean initial IOP in eyes selected for SLT was significantly higher (21.26 ± 4.82 mmHg) than in eyes selected for ALT (20.26 ± 4.01 mmHg), t test: p = 0.037. However, there was no statistically significant difference in the IOP lowering effect between eyes treated with SLT and those treated with ALT. The mean IOP drop from the pre-treatment values was -2.85 ± 4.62 mmHg after SLT and -2.63 ± 3.60 mmHg after ALT (t test, p = 0.84). All values: two hours, 24 hours, and three months after treatment were significantly lower than pre-treatment values in both groups (t test, p < 0.03). Only in the first hour after SLT was the IOP drop not significant. There was a significant correlation between the amount of pigment on the trabecular meshwork and the fall in IOP (U Mann-Whitney test). In the SLT group, six patients (21%) developed mild iritis during the first day after laser treatment, which disappeared after fluorometholon drop therapy. CONCLUSIONS: Both methods, SLT and ALT, have equivalent IOP lowering effects on short-term observation (three months). Due to the entirely new mode of the Selecta laser action, long-term results may show significant differences. LA: Polish
Dr. G. Popiela, Katedry i Kliniki Okulistyki AM we Wroclawiu, Poland. mary@okulist.am.wroc.pl
Classification:
12.4 Laser trabeculoplasty and other laser treatment of the angle (Part of: 12 Surgical treatment)
