Selective laser activation of trabecula in patients with surgically treated glaucoma

Selective laser activation of trabecula in patients with surgically treated glaucoma
E.R. Tumanyan, E.S. Ivanova, N.N. Ereskin, E.A. Subkhangulova, T.S. Lyubimova
The S. Fyodorov Eye Microsurger y Federal State Institution, Moscow

Purpose. To evaluate the effectiveness of selective laser activation of trabecula (SLAT) in patients with surgically treated POAG.

Methods. There were observed 180 eyes of 158 patients from 40 to 82 (67.3±7.6) years old with POAG treated with microinvasive non-penetrating deep sclerectomy (MNPDS) and descemetogoniopuncture (DGP). All eyes were divided into 2 groups. There were 91 eyes of 82 patients in the first group, who treated with SLAT, and 89 eyes of 76 patients who received xalatan. Follow-up was 2 years.

Results. Target intraocular pressure (IOP) was reached 1 month later in all eyes with initial and advanced stage of POAG. To reach the target IOP in far-advanced stage, the first group needed xalatan in 8 eyes (8.8%), xalatan and timolol in 11 eyes (12.1%), the second group required xalatan and timolol in all cases.
There were occasions of IOP elevation 6 months later. In such cases in first group the SLAT was repeated, in the second group timolol was added. At the end of follow-up the SLAT2 needed in all eyes with initial and advanced stage in the first group, the SLAT3 required in 12 (31.6%) eyes with advanced stage of disease.
There were 25 eyes (75.8%) with initial stage and 19 eyes (51.4%) with advanced stage received xalatan, 8 eyes (24.2%) with initial stage and 14 eyes (37.8%) with advanced stage received xalatan and timolol. A repeat MNPDS required in eyes with advanced POAG in 2 cases (2.2%) of the first group, in 4 cases (4.5%) of the second group. All eyes with far-advanced stage in both groups needed the repeat MNPDS.

Conclusion. The SLAT seems to be an alternative of medical therapy in patients with initial and advanced stage of surgically treated POAG.

Key words: primary open-angle glaucoma (POAG), target intraocular pressure, selective laser activation of trabecula (SLAT), microinvasive non-penetrating deep sclerectomy (MNPDS).
Ophthalmosurgery.— 2011.— No. 3.— P. 63-67.