Selective Laser Trabeculoplasty in Fertile Women with Open Angle Glaucoma or Ocular Hypertension

Myoung Hee Park; Jung-Il Moon

doi:10.3341/jkos.2007.48.11.1494

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Park and Moon: Selective Laser Trabeculoplasty in Fertile Women with Open Angle Glaucoma or Ocular Hypertension

Original Article

J Korean Ophthalmol Soc 2007;48(11):1494-1499.

Published online: 28 August 2007

DOI: https://doi.org/10.3341/jkos.2007.48.11.1494

Selective Laser Trabeculoplasty in Fertile Women with Open Angle Glaucoma or Ocular Hypertension

Myoung Hee Park, M.D., Jung-Il Moon, M.D.

Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea

Address reprint requests to Jung-Il Moon, M.D., Ph.D., Department of Ophthalmology, St. Mary's Hospital, The Catholic University of Korea, #62 Yoido-dong, Youngdeungpo-gu, Seoul 150-713, Korea, Tel: 82-2-3779-1243, Fax: 82-2-761-6869, E-mail: jimoon@catholic.ac.kr

Received 30 March 2007 Accepted 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the efficacy and safety of selective laser trabeculoplasty (SLT) in pregnant and lactating women who have primary open-angle glaucoma and ocular hypertension.

Methods

From January 2006 to August 2006 SLT was performed in fertile female patients with primary open-angle glaucoma and ocular hypertension. Intraocular pressure (IOP) was measured at 1 hour, 1 day, 1 week, 1 month, 3 months, and 6 months after SLT. Anterior chamber reaction and ocular pain were checked on postoperative day 1. Peripheral anterior synechia was examined at postoperative 6 months. Any anti-glaucoma drug was discontinued after SLT procedure, and restarted when needed.

Results

22 patients (40 eyes) of primary open-angle glaucoma (40 eyes) and ocular hypertension (10 eyes) were included. The mean baseline intraocular pressure was 31.6 mmHg. The mean IOP was 15.7 mmHg and the mean number of anti-glaucoma drug was 1.3±0.6 preoperatively. There was successful IOP decrease at postoperative 1 day (17.9 mmHg), 1 week (16.3 mmHg), 1 month (17.7 mmHg), 3 months (18.4 mmHg), and 6 months (19.0 mmHg). The mean number of anti-glaucoma drug was 0.43±0.7 (p=0.000) postoperatively. There were no significant postoperative complications in the 6-month follow-up period.

Conclusions

SLT seems to be a safe and effective procedure for fertile female patients who need to discontinue or reduce the anti-glaucoma drugs.

Keywords: Fertility, Lactation, Open Angle Glaucoma, Pregnancy, Selective Laser Trabeculoplasty

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Figure 1.

Changes in intraocular pressure after selective laser trabeculoplasty.

Table 1.

Patient demographics

Age (mean±SD) (years)	28.0±3.2
Gender (No. of eyes)
Female	22 (40)
Diagnosis (No. of eyes)
POAG^*	15 (30)
OHT^†	5 (10)
No. of Medication (mean±SD)	1.3±0.6
Baseline IOP^‡ (mean±SD) (mmHg)	31.6±6.6
Pre-laser IOP with medication (mean±SD) (mmHg)	15.7±2.1

^* POAG=Primary open-angle glaucoma.

^† OHT=Ocular hypertension.

^‡ IOP=Intraocular pressure.

Table 2.

Mean Changes in intraocular pressure after selective laser trabeculoplasty

	Pre-laser	1 d	1 wk	1 mo	3 mos	6 mos
IOP^* (mmHg)	15.7±2.1	17.9±4.0	16.3±4.8	17.7±5.2	18.4±4.5	19.0±5.5
No. of eyes	40	40	40	40	40	40
p^†		0.001	0.444	0.017	0.000	0.000

^* IOP=intraocular pressure.

^† General linear model/repeated measure/Wilks’ Lamda.

Table 3.

Success rate of selective laser trabeculoplasty

	Success	Qualified success	Failure
Rate (No. of eyes)	55% (22)	15% (6)	30% (12)

Table 4.

Changes of the number of anti-glaucoma medications used (No. of eyes)

No. of medication	Pre-laser	6 mos
0	0	26
1	30	11
2	10	3
Total no. of eyes	40	40
p^*	0.000

^* Wilcoxon signed ranks test.

Table 5.

Complications after selective laser trabeculoplasty

Complications	Rate (No. of eyes)
Anterior chamber reaction	50% (20)
Ocular pain	8% (3)
Transient IOP^* spike	8% (3)
PAS^† formation^‡	0% (0)

^* IOP = intraocular pressure.

^† PAS = peripheral anterior synechia

^‡ Observed at postoperative 6 months.

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