Myoung Hee Park; Jung-Il Moon

doi:10.3341/jkos.2007.48.11.1500

Journal List > J Korean Ophthalmol Soc > v.48(11) > 1007962

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Park and Moon: A Comparison of Efficacy and Safety Between 90° and 180° Selective Laser Trabeculoplasty

Original Article

J Korean Ophthalmol Soc 2007;48(11):1500-1505.

Published online: 28 August 2007

DOI: https://doi.org/10.3341/jkos.2007.48.11.1500

A Comparison of Efficacy and Safety Between 90° and 180° Selective Laser Trabeculoplasty

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., 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 20 March 2006 Accepted 10 October 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 compare the intraocular pressure-lowering effect and safety between 180° and 90° selective laser trabeculoplasty (SLT).

Methods

From January 2006 to august 2006, in patients with primary open-angle glaucoma and ocular hypertension, SLT was performed 90° to the right eye and 180° to the left eye within the same patient. Intraocular pressure was checked at 1 hour, 1 day, 1 week, 1 month, 3 months, and 6 months after SLT. Anterior chamber reaction and ocular pain was checked at postoperative 1 day. Peripheral anterior synechia was examined at 6 months postoperatively.

Results

Fourteen patients (28 eyes) of primary open-angle glaucoma and two patients (4 eyes) of ocular hypertension were included. There was no difference of intraocular pressure between 180° group and 90° group preoperatively. However, there were statistically significant differences from postoperative 1 hour (p=0.003), through 1 week (15.6±2.3 mmHg in 90° group, 14.0±2.5 mmHg in 180° group; p=0.000), to 6 months (p=0.001). Thirty-two percent of the 90° group and Seventy-five percent of the 180° group showed successful intraocular pressure decrease. There was a slightly higher complication rate of anterior chamber reactions and transient intraocular pressure spikes in the 180° group.

Conclusions

Performing 180° SLT seems the safest procedure that guarantees the successful intraocular pressure decrease.

Keywords: Intraocular Pressure, Open Angle Glaucoma, Selective Laser Trabeculoplasty, Trabecular Meshwork

References

1. Latina MA, Park C. Selective targeting of trabecular meshwork cells: in vitro studies of pulsed and CW laser interactions. Exp Eye Res. 1995; 60:359–72.

2. Latina MA, Sibayan SA, Shin DH, et al. Q-switched 532-nm Nd:YAG laser trabeculoplasty (selective laser trabeculoplasty): a multicenter, pilot, clinical study. Ophthalmology. 1998; 105:2082–8.

3. Kramer TR, Noecker RJ. Comparison of the morphologic changes after selective laser trabeculoplasty and argon laser trabeculoplasty in human eye bank eyes. Ophthalmology. 2001; 108:773–9.

4. Latina MA, DeLeon JM. Selective laser trabeculoplasty. Ophthalmol Clin North Am. 2005; 18:409–19.

5. Stein JD, Challa P. Mechanisms of action and efficacy of argon laser trabeculoplasty and selective laser trabeculoplasty. Curr Opin Ophthalmol. 2007; 18:140–5.

6. Jurych MS, Chopra V, Banitt MR, et al. Comparison of long-term outcomes of selective laser trabeculoplasty versus argon laser trabeculoplasty in open-angle glaucoma. Ophthalmology. 2004; 111:1853–9.

7. Weinand FS, Althen F. Long-term clinical results of selective laser trabeculoplasty in the treatment of primary open angle glaucoma. Eur J Ophthalmol. 2006; 16:100–4.

8. Lai JS, Chua JK, Tham CC, Lam DS. Five-year follow up of selective laser trabeculoplasty in Chinese eyes. Clin Experiment Ophthalmol. 2004; 32:368–72.

9. Martinez-de-la-Casa JM, Garcia-Feijoo J, Castillo A, et al. Selective vs argon laser trabeculoplasty: hypotensive efficacy, anterior chamber inflammation, and postoperative pain. Eye. 2004; 18:498–502.

10. Kajiya S, Hayakawa K, Sawaguchi S. Clinical results of selective laser trabeculoplasty. Jpn J Ophthalmol. 2000; 104:160–4.

11. Kim JS, Lee YG, Hong YJ. Q-switched, frequency doubled Nd:YAG laser trabeculoplasty. J Korean Ophthalmol Soc. 1999; 40:2591–6.

12. Lee HY, Baek NH, Moon JI. Comparison of short-term outcomes of argon laser versus selective laser trabeculoplasty in open-angle glaucoma. J Korean Ophthalmol Soc. 2005; 46:2004–9.

13. Suhk HJ, Kook MS. Three year follow up of laser trabeculoplasty using Q-switched frequency doubled Nd:YAG laser. J Korean Ophthalmol Soc. 2003; 44:93–9.

14. Chen E, Golchin S, Blomdahl S. A comparison between 90° and 180° selective laser trabeculoplasty. J Glaucoma. 2004; 13:62–5.

15. Song J, Lee PP, Epstein DL, et al. High failure rate associated with 180° selective laser trabeculoplasty. J Glaucoma. 2005; 14:400–8.

16. McIlraith I, Strasfeld M, Colev G, Hutnik CM. Selective laser trabeculoplasty as initial and adjunctive treatment for open-angle glaucoma. J Glaucoma. 2006; 15:124–30.

Figure 1.

Changes in intraocular pressure after selective laser trabeculoplasty.

Figure 2.

Mean reduction of intraocular pressure from baseline intraocular pressure (percentage) after selective laser trabeculoplasty.

Table 1.

Patient demographics

Age (mean±SD) (years)	52.7±17.0
Gender
Male	7
Female	9
Diagnosis
POAG^*	14
OHT^†	2
No. of Medication (mean±SD)	1.8±0.8
Baseline IOP^‡ (mean±SD) (mmHg)
OD	16.3±1.5^§
OS	16.8±1.8

^* POAG = primary open angle glaucoma.

^† OHT = ocular hypertension.

^‡ IOP = intraocular pressure.

^§ Wilcoxon signed ranks test, p>0.05.

Table 2.

Mean changes in intraocular pressure after selective laser trabeculoplasty

		Baseline	1 d	1 wk	1 mo	3 mos	6 mos
90° group	IOP^* (mmHg)	16.3± 1.5	15.6±2.3	14.8±3.0	14.2±3.3	15.3±3.0	15.3±3.1
90° group	% of decrease^†		4.5	10.1	14.8	6.5	6.5
180° group	IOP (mmHg)	16.8±1.8	14.0±2.5	12.8±3.6	13.1±2.7	13.8±3.0	13.6±3.1
180° group	% of decrease^†		16.4	27.3	24.4	18.1	19.8
	p^‡	>0.05	0.004	0.001	0.003	0.005	0.004

^* IOP = intraocular pressure.

^† % of decrease from baseline IOP.

^‡ Wilcoxon signed ranks test.

Table 3.

Success rate of selective laser trabeculoplasty (No. of eyes)

	Success	Fail
	Success	No Change	IOP^* Increase
90° group	32% (5)	68% (11)
90° group		56% (9)	12% (2)
180° group	75% (12)	25% (4)
180° group		19% (3)	6% (1)

^* IOP = intraocular pressure

Table 4.

Complications after selective laser trabeculoplasty (No. of eyes)

Complications	90° group	180° group
Anterior chamber reaction	25% (4)	50% (8)
Ocular pain	6% (1)	6% (1)
Transient IOP^* spike	0% (0)	7% (2)
PAS^† formation^‡	0% (0)	0% (0)

^* IOP = intraocular pressure.

^† PAS = peripheral anterior synechia.

^‡ observed at postoperative 6 months.

TOOLS

Similar articles