Abstract
Background
In this retrospective comparative cohort outcome study, the influence of Selective Laser Trabeculoplasty (SLT) on combined clear cornea phacoemulsification and ab interno trabeculectomy (Trabectome) outcomes in Primary Open Angle Glaucoma (POAG), Pseudoexfoliation Glaucoma (PEX), and Pigmentary Glaucoma (PG) was examined.
Methods
Combined clear cornea phacoemulsification and Trabectome were performed in 27 consecutive patients with POAG, in 27 patients with PEX, and in 20 patients with PG. Each group was divided into two subgroups including patients without SLT treatment prior to surgery and patients who had insufficient response to 360° SLT treatment three months prior to surgery.
Results
In the SLT group, mean IOP at six months measured 13.33 ± 2.08 mmHg with an average decrease of 30 % from preoperative IOP in the POAG group, 12.10 ± 1.40 mmHg with an average decrease of 46 % in the PEX group, and 11.83 ± 2.21 mmHg with an average decrease of 38 % in the PG group. In eyes without previous SLT, mean IOP sixt 6 months measured 11.00 ± 1.73 mmHg with an average decrease of 38 % from preoperative IOP in the POAG group, 15.50 ± 1.41 mmHg with an average decrease of 35 % in the PEX group, and 15.67 ± 2.91 mmHg with an average decrease of 36 % in the PG group, respectively.
Conclusions
Prior SLT treatment seems not to negatively influence combined clear cornea phacoemulsification and Trabectome outcomes in glaucoma patients. However, SLT treatment may even have an additive effect on following combined Trabectome outcomes in patients with PEX and PG.
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References
Tezel G, Kass MA, Kolker AE, Wax MB (1996) Comparative optic disc analysis in normal pressure glaucoma, primary open-angle glaucoma, and ocular hypertension. Ophthalmology 103:2105–2113
Cvenkel B, Kontestabile AS (2011) Correlation between nerve fibre layer thickness measured with spectral domain OCT and visual field in patients with different stages of glaucoma. Graefes Arch Clin Exp Ophthalmol 249:575–584
Ritch R (1994) Exfoliation syndrome. The most common identifiable cause of open-angle glaucoma. J Glaucoma 3:176–178
Niyadurupola N, Broadway DC (2008) Pigment dispersion syndrome and pigmentary glaucoma–a major review. Clin Exp Ophthalmol 36:868–882
Latina MA, Sibayan SA, Shin DH, Noecker RJ, Marcellino G (1998) Q-switched 532-nm Nd:YAG laser trabeculoplasty (selective laser trabeculoplasty): a multicenter, pilot, clinical study. Ophthalmology 105:2082–2088
Damji KF, Bovell AM, Hodge WG, Rock W, Shah K, Buhrmann R, Pan YI (2006) Selective laser trabeculoplasty vs argon laser trabeculoplasty: results from a 1-year randomised clinical trial. Br J Ophthalmol 90:1490–1494
Hodge WG, Damji KF, Rock W, Buhrmann R, Bovell AM, Pan Y (2005) Baseline IOP predicts selective laser trabeculoplasty success at 1 year post-treatment: results from a randomised clinical trial. Br J Ophthalmol 89:1157–1160
Francis BA, Ianchulev T, Schofield JK, Minckler DS (2005) Selective laser trabeculoplasty as a replacement for medical therapy in open-angle glaucoma. Am J Ophthalmol 140:524–525
Johnson PB, Katz LJ, Rhee DJ (2006) Selective laser trabeculoplasty: predictive value of early intraocular pressure measurements for success at 3 months. Br J Ophthalmol 90:741–743
Juzych MS, Chopra V, Banitt MR, Hughes BA, Kim C, Goulas MT, Shin DH (2004) Comparison of long-term outcomes of selective laser trabeculoplasty vs argon laser trabeculoplasty in open-angle glaucoma. Ophthalmology 111:1853–1859
McIlraith I, Strasfeld M, Colev G, Hutnik CM (2006) Selective laser trabeculoplasty as initial and adjunctive treatment for openangle glaucoma. J Glaucoma 15:124–130
Melamed S, Ben Simon GJ, Levkovitch-Verbin H (2003) Selective laser trabeculoplasty as primary treatment for open-angle glaucoma: a prospective, nonrandomized pilot study. Arch Ophthalmol 121:957–960
Nagar M, Ogunyomade A, O’Brart DP, Howes F, Marshall J (2005) A randomised, prospective study comparing selective laser trabeculoplasty with latanoprost for the control of intraocular pressure in ocular hypertension and open angle glaucoma. Br J Ophthalmol 89:1413–1417
Klamann MK, Maier AK, Gonnermann J, Ruokonen PC (2012) Adverse Effects and Short-term Results After Selective Laser Trabeculoplasty (SLT). J Glaucoma; [Epub ahead of print]
Koucheki B, Hashemi HJ (2012) Selective laser trabeculoplasty in the treatment of open-angle glaucoma. J Glaucoma 21:65–70
Ting JL, Damji KF, Stiles MC; Trabectome Study Group (2012) Ab interno trabeculectomy: outcomes in exfoliation versus primary open-angle glaucoma. J Cataract Refract Surg 38:315–323
Vold SD, Dustin L, Trabectome Study Group (2010) Impact of laser trabeculoplasty on Trabectome® outcomes. Ophthalmic Surg Lasers Imaging 41:443–451
AGIS Investigators (2002) The Advanced Glaucoma Intervention Study (AGIS): 11. Risk factors for failure of trabeculectomy and argon laser trabeculoplasty. Am J Ophthalmol 134:481–498
Wimmer I, Welge-Luessen U, Picht G, Grehn F (2003) Influence of argon laser trabeculoplasty on transforming growth factor-beta 2 concentration and bleb scarring following trabeculectomy. Graefes Arch Clin Exp Ophthalmol 241:631–636
Töteberg-Harms M, Rhee DJ (2013) Selective Laser Trabeculoplasty Following Failed Combined Phacoemulsification Cataract Extraction and Ab Interno Trabeculectomy. Am J Ophthalmol 156:936–940
Higginbotham EJ, Richardson TM (1986) Response of exfoliation glaucoma to laser trabeculoplasty. Br J Ophthalmol 70:837–839
Ayala M, Chen E (2011) Predictive factors of success in selective laser trabeculoplasty (SLT) treatment. Clin Ophthalmol 5:573–576
Jea SY, Francis BA, Vakili G, Filippopoulos T, Rhee DJ (2012) Ab interno trabeculectomy versus trabeculectomy for open-angle glaucoma. Ophthalmology 119:36–42
Jampel HD, Musch DC, Gillespie BW, Lichter PR, Wright MM, Guire KE; Collaborative Initial Glaucoma Treatment Study Group (2007) Perioperative complications of trabeculectomy in the Collaborative Initial Glaucoma Treatment Study (CIGTS). Am J Ophthalmol 140:16–22
Gedde SJ, Herndon LW, Brandt JD, Budenz DL, Feuer WJ, Schiffman JC (2007) Tube Versus Trabeculectomy Study Group. Surgical complications in the Tube Versus Trabeculectomy Study during the first year of follow-up. Am J Ophthalmol 143:23–31
Klamann MK, Gonnermann J, Maier AK, Ruokonen PC, Torun N, Joussen AM, Bertelmann E (2013) Combined clear cornea phacoemulsification in the treatment of pseudoexfoliative glaucoma associated with cataract: Significance of trabecular aspiration and ab interno trabeculectomy. Graefes Arch Clin Exp Ophthalmol 251:2195–2199
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Matthias K. J. Klamann and Johannes Gonnermann joint first authors.
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Klamann, M.K.J., Gonnermann, J., Maier, AK.B. et al. Influence of Selective Laser Trabeculoplasty (SLT) on combined clear cornea phacoemulsification and Trabectome outcomes. Graefes Arch Clin Exp Ophthalmol 252, 627–631 (2014). https://doi.org/10.1007/s00417-014-2569-7
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DOI: https://doi.org/10.1007/s00417-014-2569-7