SELECTIVE LASER TRABECULOPLASTY AS PRIMARY THERAPY IN PATIENTS WITH GLAUCOMA: FIVEYEAR EXPERIENCE

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SELECTIVE LASER TRABECULOPLASTY AS PRIMARY
THERAPY IN PATIENTS WITH GLAUCOMA FIVE-YEAR
EXPERIENCE

• Lawrence F. Jindra, MD
• Arusha Gupta, MD
• Elaine M. Miglino

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Financial Disclosures

• 1st author has independently conducted and
  financed clinical research study presented and
  provides technical advice and consultant services
  to Lumenis Corporation.
• 2nd and 3rd authors have no financial
  disclosure.

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Introduction

• Selective Laser Trabeculoplasty (SLT) uses a
  Q-Switched frequency-doubled (532 nm) NdYAG
  laser which targets melanocytes in the pigmented
  trabecular meshwork.1,2 When treated with SLT, a
  primarily biologic response is induced in the
  trabecular meshwork which involves the release of
  cytokines that trigger macrophage recruitment and
  other changes leading to IOP reduction.2 It
  treats the meshwork without causing any thermal
  or coagulative damage to surrounding
  structures.1,2

1. Latina MA, et al. Selective targeting of
trabecular meshwork cells in vitro studies of
pulsed and cw laser interactions. Exp Eye Res.
199560359-372. 2. Latina MA, et al. Q-switched
532-nm NdYAG laser trabeculoplasty (selective
laser trabeculoplasty) a multicenter, pilot,
clinical study. Ophthalmology. 19981052082-2090.
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Objective and Methods

• To evaluate SLT as primary therapy (eyes not
  treated with medications) in decreasing
  intraocular pressure (IOP) in patients with
  glaucoma.
• A retrospective chart review was performed on
  879 of 2056 eyes in a consecutive case series
  from patients treated with SLT as primary therapy
  over 5 years between 2002 and 2007. Two-tailed
  paired t-test was used to compare maximum pre-
  and post-SLT IOP.

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Results IOP

• 879 eyes received SLT as primary treatment
  for glaucoma mean follow-up was 513 days.
• IOP decreased from a mean of 19.0 mm Hg
  4.0 to 13.1 mm Hg 3.4. This represents a 31
  decrease in IOP or 5.9 mm Hg.
• Failure rate (repeat SLT or meds) was 7 of
  eyes treated.
• Data were significant with P lt 0.01.

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Data IOP
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Results IOP
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Summary

• Mean Post-SLT reduction in
• IOP 31
• The results were significant with P lt 0.01.

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Conclusion

• In this clinical series, SLT significantly
  lowered intraocular pressure, when used as
  primary treatment for glaucoma.