Saratov JOURNAL of Medical and Scientific Research

Effectiveness of selective laser trabeculoplasty in the complex treatment of primary open-angle glaucoma

Year: 2021, volume 17 Issue: №2 Pages: 319-322
Heading: Тhematic supplement Article type: Original article
Authors: Konovalov M.E., Burdel K.V., Zenina M.L., Konovalova M.M.
Organization: Institute for Advanced Studies of the Federal Medical and Biological Agency of Russia, Konovalov eye center, Moscow, S. Botkin City Clinical Hospital, Moscow
Summary:

Purpose: to determine the effectiveness of selective laser trabeculoplasty in the complex treatment of open-angle glaucoma. Material and Methods. Study group: 47 patients (53 eyes), mean age 70.0±9.1 (Cl 69.8-73.1) years; men 44.7% (n=21), women 55.3% (n=26). Patients with stages 1-3 of open-angle glaucoma underwent tonometry, computed perimetry and ОСТ of the optic nerve disc at the beginning of the study and at least 6 months after the SLT Decrease in IOP was defined as the difference between the pressure obtained within at least 6 months of observation and the initial level of IOP. Results. IOP before SLT was Me=24.0 mmHg (Q1-Q3: 21.0-28.0 mmHg), after Me=20.0 mmHg (Q1-Q3: 17.0-21.0 mmHg). Decrease in IOP was Me=4.0 mmHg (Q1-Q3: 3.0-8.0 mmHg). IOP after SLT significantly decreased (p<0.05) in 88.7% of cases. There was no statistically significant association between the variable "IOP decrease" and the stage of glaucoma (p=0.215), as well as between the decrease in IOP and previous glaucoma surgery (p=0.664). The correlation between the baseline value and the magnitude of the decrease in IOP is statistically significant (p<0.05, r =0.73). A linear dependence was obtained, at which, with an increase in the initial IOP by 1 mmHg decrease in IOP level will increase by 0.75 mmHg. Conclusion. SLT is an effective and safe method for lowering IOP, which makes it possible to recommend this procedure more often for all patients with open-angle glaucoma.

Bibliography:
1. Lee JW, Chan JC, Chang RT, et al. Corneal changes after a single session of selective laser trabeculoplasty for open-angle glaucoma. Eye (Lond) 2014 Jan; 28 (1): 47-52.
2. Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol 2006 Mar; 90 (3): 262-7.
3. Chan HH, Ong DN, Kong YX, et al. Glaucomatous optic neuropathy evaluation (GONE) project: the effect of monoscopic versus stereoscopic viewing conditions on optic nerve evaluation. Am J Ophthalmol 2014 May; 157 (5): 936-44.
4. Tezel G, Wax MB. Glial modulation of retinal ganglion cell death in glaucoma. J Glaucoma 2003 Feb; 12 (1): 63-8.
5. Lee R, Hutnik CM. Projected cost comparison of selective laser trabeculoplasty versus glaucoma medication in the Ontario Health Insurance Plan. Can J Ophthalmol 2006 Aug; 41 (4): 449-56.
6. Cantor LB, Katz LJ, Cheng JW, et al. Economic evaluation of medication, laser trabeculoplasty and filtering surgeries in treating patients with glaucoma in the US. Curr Med Res Opin 2008 Oct; 24 (10): 2905-18.
7. Durr GM, Harasymowycz P. The effect of repeat 360-degree selective laser trabeculoplasty on intraocular pressure control in open-angle glaucoma. J Fr Ophtalmol 2016 Mar; 39(3): 261-4.
8. Francis BA, Loewen N, Hong B, et al. Repeatability of selective laser trabeculoplasty for open-angle glaucoma. ВМС Ophthalmol 2016 Jul 28; 16: 128.
9. Alvarado JA, Chau P, Wu J, et al. Profiling of Cytokines Secreted by Conventional Aqueous Outflow Pathway Endothelial Cells Activated In Vitro and Ex Vivo with Laser Irradiation. Invest Ophthalmol Vis Sci 2015 Nov; 56 (12): 7100-8.
10. Bradley JM, Anderssohn AM, Colvis CM, et al. Mediation of laser trabeculoplasty-induced matrix metalloproteinase expression by IL-1 beta and TNF-alpha. Invest Ophthalmol Vis Sci 2000 Feb; 41 (2): 422-30.
11. Lee JY, Lee YK, Moon Jl, et al. Long-term outcomes and predictive factors for success of selective laser trabeculoplasty. J Korean Ophthalmol Soc 2014; 55 (9): 1347.
12. Toteberg-Harms M, Meier-Gibbons F. Is laser trabeculoplasty the new star in glaucoma treatment? Curr Opin Ophthalmol 2021 Mar 1; 32 (2): 141-7.
13. Ansari E. 10-year outcomes of first-line selective laser trabeculoplasty (SLT) for primary open-angle glaucoma (POAG). GraefesArch Clin Exp Ophthalmol 2021 Jun; 259 (6): 1597-604.
14. Gazzard G, Konstantakopoulou E, Garway-Heath D, et al. Selective laser trabeculoplasty versus drops for newly diagnosed ocular hypertension and glaucoma: the LiGHT RCT. Health Technol Assess 2019 Jun; 23 (31): 1-102.
15. Di X, Fan X, Zhou JC, Wu LL. Effectiveness of unilateral selective laser trabeculoplasty for primary open-angle glaucoma. Zhonghua Yan Ke Za Zhi 2016 Jun 11; 52 (6): 410-5.
16. Diallo JW, Ahnoux-Zabsonre A, Dolo-Traore M, et al. Resultats tonometriques preliminaires de la trabeculoplastie selective au laser (SLT) chez les glaucomateux au Burkina Faso [Preliminary selective laser trabeculoplasty (SLT) intraocular pressure results in glaucoma patients in Burkina Faso]. J Fr Ophtalmol 2021 Mar; 44 (3): 409-14.
17. Kennedy JB, SooHoo JR, Kahook MY, Seibold LK. Selective Laser Trabeculoplasty: An Update. Asia Рас J Ophthalmol (Phila) 2016 Jan-Feb; 5 (1): 63-9.
18. Khawaja AP, Campbell JH, Kirby N, et al. UK Glaucoma Real-World Data Consortium: Real-World Outcomes of Selective Laser Trabeculoplasty in the United Kingdom. Ophthalmology 2020 Jun; 127 (6): 748-57.
19. Pillunat KR, Spoerl E, Elfes G, Pillunat LE. Preoperative intraocular pressure as a predictor of selective lasertrabeculoplasty efficacy. Acta Ophthalmol 2016 Nov; 94 (7): 692-6.
20. Greninger DA, Lowry EA, Porco TC, et al. Resident-performed selective laser trabeculoplasty in patients with open-angle glaucoma. JAMA Ophthalmol 2014 Apr 1; 132 (4): 403-8.

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