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1.
Philippine Journal of Ophthalmology ; : 4-9, 2023.
Article in English | WPRIM | ID: wpr-982912

ABSTRACT

Objective@# This study compared the economic viability of initial medical therapy with topical prostaglandin analogues (PGAs) versus selective laser trabeculoplasty (SLT) in the treatment of primary open-angle glaucoma (POAG).@*Method@#This was an economic analysis using actual, current treatment costs of PGA therapy versus SLT applied to theoretical, literature-derived clinical efficacy data projected for a period of 19 years. A socioeconomic and demographic survey conducted among POAG patients at the Department of Health Eye Center of the East Avenue Medical Center from March-April 2022 provided the economic context and setting for the analysis. The treatment regimens were compared in terms of total cost, clinical efficacy, cost-effectiveness and cost-utility in the setting of a tertiary government hospital.@*Results@#Thirty-one (31) patients were included in the study. The total annual cost of topical PGAs was Philippine Pesos (Php) 13,532 versus Php 6,195 for SLT. Cost-effectiveness was Php 1,933 for PGAs/mmHg reduction in intraocular pressure (IOP) versus Php 983 for SLT. Cost-utility was Php 59,793/Quality Adjusted Life Years (QALY) gained for PGAs versus Php 27,373/QALY gained for SLT projected for 19 years. With government insurance coverage, cost-utility ratio was Php 47,831/QALY gained for topical PGAs versus 16,327/QALY gained for SLT.@*Conclusion@#In POAG patients, SLT was more cost-effective versus PGAs with a lower cost per mmHg IOP reduction, and lower cost-utility ratio for every QALY gained. SLT can be recommended as initial therapy for POAG especially for patients being treated at tertiary government hospitals.


Subject(s)
Economics , Glaucoma , Prostaglandins, Synthetic , Quality-Adjusted Life Years , Philippines
2.
Article | IMSEAR | ID: sea-219954

ABSTRACT

Background: Glaucoma is the most common cause of blindness in the world. If not recognized and treated early enough, open-angle glaucoma can be a severe ocular illness that can lead to blindness. A gradual loss of ganglion cells leads to the optic nerve head cupping, which is the pathogenic process. Objective: The main aim of this study was to determine if selective laser trabeculoplasty (SLT) is superior to topical medication as the first-line treatment for open-angle glaucoma.Material & Methods:This prospective comparative study was conducted in 225 patients (450 eyes) at Deen Mohd. Eye Hospital & Research Center from July 2019 to July 2021.The patients were randomly divided into two groups; Selective laser trabeculoplasty (SLT group)and medical therapy group.Results:The study was conducted between 25 to 85 years of patients where the majority were between 46 to 65 years age group;58% patientswere male, and 42% were female. The mean intraocular pressure (IOP) was 18.2mm Hg for the SLT group and 17.6mm Hg for the medical therapy group. Overall, mean pressures and IOP lowering were not statistically different between the two treatment groups.Conclusions:In the last follow-up, 11% of the eyes had been stepped to additional SLT in the SLT arm, and 27% of the eyes in the medical arm required more medications to reach the target IOP range. The main risk factor is high intraocular pressure; however additional potential risk factors include optic nerve vascular insufficiency, neuronal degeneration, and hereditary factors. More research and prospective trials on intraocular pressure control and disease progression are needed to understand the long-term implications.

3.
International Eye Science ; (12): 2113-2117, 2021.
Article in Chinese | WPRIM | ID: wpr-904685

ABSTRACT

@#AIM: To assess and compare the effectiveness of selective laser trabeculoplasty(SLT)in preventing primary open angle glaucoma(POAG)with various stages.<p>METHODS: Fifty-one eyes of 27 patients 51 eye with POAG were included in this retrospective study. All the cases were divided into three groups depending on the mean deviation(MD): the early stage group(MD>-6dB, 15 eyes), middle stage group(-12dB≤MD≤-6dB, 15 eyes)and late stage group(MD<-12dB, 21 eyes). All subjects underwent SLT on 360° of the angle between July 2018 to March 2020. The laser parameters of a 532nm, Q-switched, frequency-doubled Nd: YAG laser, with 3ns pulse time, 400μm spot diameter were set to selectively target pigmented trabecular meshwork cells without visible damage to the adjacent non-pigmented tissue. Intraocular pressure(IOP)reduction was observed at 1h, 1d, 1, 3, 6 and 12mo after the laser procedure. Meanwhile, the ratio of the IOP reduction, visual field index(VFI), MD, medication, adverse reactions and efficiency were assessed as well.<p>RESULTS: Within the 12mo post-SLT, there were no statistically significant differences for the IOP and IOP decline rate between each group(all <i>P</i>>0.05). There were significant differences in VFI and MD among early, middle and late groups(<i>P</i><0.001), within the 12mo post-SLT, no statistically significant differences were detected for the decline of VFI and MD in each group. In terms of the early stage group, the effective rates of SLT at 1, 3, 6 and 12mo after treatment were 100%, 93%, 87%, 67%, respectively. For the middle stage group and late stage group, the effective rates were 87%, 80%, 93%, 60%, and 67%, 71%, 62%, 19%, respectively. <p>CONCLUSION: SLT was an effective treatment for POAG patients in various stages, while the effective rate decreased with time.

4.
Chinese Journal of Experimental Ophthalmology ; (12): 892-897, 2021.
Article in Chinese | WPRIM | ID: wpr-908604

ABSTRACT

Objective:To investigate the relationship between the function of Schlemm canal and the efficacy of selective laser trabeculoplasty (SLT) in patients with primary open-angle glaucoma (POAG).Methods:An observational case series study was conducted.Seventeen POAG patients (25 eyes), including 12 males (18 eyes) and 5 females (7 eyes), were enrolled in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from March to December, 2017.The three-mirror contact lens was adopted to observe the presence of blood reflux in Schlemm canal before aerobic exercise, and positive referred to that blood reflux was observed in any region of Schlemm canal, and negative was defined as that no blood reflux was observed in Schlemm canal.The intraocular pressure (IOP) and blood pressure of subjects were measured before and after exercise test by the non-contact tonometer and automatic blood pressure monitor respectively.Positive referred to the IOP reduction ≥4.6 mmHg (1 mmHg=0.133 kPa) and negative was defined as the IOP reduction <4.6 mmHg.Optical coherence tomography (OCT) was used to observe whether Schlemm canal was dilated or not and the dilated area before and after exercise test.Positive referred to the opening clock position of Schlemm canal was larger and/or the Schlemm canal was dilated at one or more clock position.The subjects presenting positive in above three indicators were classified as the positive Schlemm canal function group (8 eyes). The subjects presenting positive in above one or two indicators were classified as the mixed Schlemm canal function group (11 eyes). The subjects presenting negative in above three indicators were classified as the negative Schlemm canal function group (6 eyes). All subjects received SLT treatment.The IOP was examined at postoperative 1 week, 2 weeks and 1 month.The IOP, IOP reduction and rate of IOP reduction were compared among the three groups at various time points.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (No.TJ-IRB20160306). Written informed consent was obtained from each subject.Results:The preoperative IOP and postoperative 1-week, 2-week and 1-month IOP were (20.33±9.22), (17.10±2.98), (19.00±3.94) and (19.33±4.32) mmHg of negative Schlemm canal function group, (25.75±9.03), (20.00±7.60), (19.18±4.46) and (18.00±3.63) mmHg of mixed Schlemm canal function group and (22.28±4.78), (18.75±8.53), (15.50±4.98) and (14.38±3.24) mmHg of positive Schlemm canal function group, respectively.There was no statistical significance in the IOP value among the three groups ( Fgroup=1.028, P=0.374). The difference in IOP before and after surgery was statistically significant ( Ftime=6.751, P=0.002). Compared with preoperative IOP, the postoperative 1-week IOP of the negative Schlemm canal function group, the postoperative 1-week, 2-week and 1-month IOP of the mixed Schlemm canal function group, and the postoperative 2-week and 1-month IOP of positive Schlemm canal function group were significantly decreased (all at P<0.05). There was no significant difference in IOP reduction or the rate of IOP reduction among the three groups after operation ( Fgroup=0.952, P=0.401; Ftime=0.828, P=0.402; Fgroup=1.840, P=0.182; Ftime=0.419, P=0.660). Conclusions:POAG patients with better function of Schlemm canal have a better IOP-lowering efficacy after SLT treatment.Blood reflux in Schlemm canal before exercise, reduced IOP and dilated Schlemm canal after exercise can be considered as indicators to evaluate Schlemm canal function.

5.
International Eye Science ; (12): 1215-1217, 2019.
Article in Chinese | WPRIM | ID: wpr-742629

ABSTRACT

@#AIM: To investigate the efficacy of selective laser trabeculoplasty(SLT)for lowering intraocular pressure(IOP)in patients with emulsified- silicone oil related secondary open angle glaucoma(SO-OAG).<p>METHODS: By a retrospective case study, consecutive case series of 120 eyes with sustained elevation of IOP after SO-OAG removal were treated by 360° SLT treatment. The mean IOP, mean number of glaucoma medications, and success rates at baseline 1wk, 1mo, 3mo were evaluated.<p>RESULTS: After the SLT treatment, the mean baseline IOP was significantly decreased from 25.02±5.93mmHg to 17.64±4.52mmHg at 1wk(<i>P</i>=0.002), 18.96±3.33mmHg at 1mo(<i>P</i>=0.04), and 18.03±5.69mmHg at 3mo(<i>P</i>=0.03). The mean number of glaucoma medications significantly decreased from 3.11±0.62 to 1.78±0.14 at 1wk(<i>P</i>=0.006), 1.95±0.56 at 1mo(<i>P</i>=0.04), and 1.87±0.53 at 3mo(<i>P</i>=0.02). The complete and qualified success rate were 68.3%(82 eyes)and(20.0%)(24 eyes)at 1wk, 61.7%(74 eyes)and 17.5%(21 eyes)at 1mo, and 64.2%(77 eyes)and 12.5%(15 eyes)at 3mo.<p>CONCLUSION: SLT may be effective for lowering IOP in patients with SO-OAG which was not controlled with maximum antiglaucomatous medical treatment.

6.
Indian J Ophthalmol ; 2018 Nov; 66(11): 1539-1553
Article | IMSEAR | ID: sea-196988

ABSTRACT

While lasers have been used for many years for the treatment of glaucoma, proper indications and use of the procedures need to be considered before their application. This review summarizes the important laser procedures in Glaucoma.

7.
Chinese Journal of Experimental Ophthalmology ; (12): 859-863, 2018.
Article in Chinese | WPRIM | ID: wpr-699835

ABSTRACT

Objective To evaluate the efficiency and safety of micropulse laser trabeculoplasty (MLT) for open angle glaucoma ( OAG) patients and ocular hypertension ( OHT) patients. Methods A prospective self-controlled study was designed. Fifty-six eyes of 56 OAG and OHT patients in Peking University Third Hospital were recruited from June 2016 to June 2017,including 32 males and 24 females with the age of (50. 4±19. 0) years old. The diagnosis included 48 eyes of primary open angle glaucoma (POAG),3 eyes of normal tension glaucoma and 5 eyes of OHT. The best corrected vision acuity ( BCVA) was 0. 7 ±0. 3 before treatment. The intraocular pressure (IOP) before MLT was (20.4±5.8) mmHg,the average types of antiglaucoma medications was 1.7,including systemic medication and local drug use. The general information, BCVA, IOP and antiglaucoma medication were recorded. Only one eye of each patient was treated by MLT. The IOP at different follow-up time points (2 hours, 1 day,1 week, 1 month, 3 months post-treatment) and the number of antiglaucoma medication before and after treatment were compared. This study protocol was approved by Ethic Committee of Peking University Third Hospital (No. 2014166). Written informed consent was obtained from each subject prior to any medical examination. Results The IOP after MLT was (20. 2±6. 7),(17. 6±4. 4),(18. 1±4. 5),(17. 4±3. 4) and (17. 0±2. 1)mmHg at 2 hours, 1 day,1 week,1 month and 3 months,respectively,with significant difference among the different time points ( F=7. 320,P<0. 001). Compared with the IOP before treatment,the IOP at 1 day,1 week,1 month and 3 months after treatment were significantly decerased,with significant differences between them (all at P<0. 05). Three months after treatment,the average number of glaucoma medications used was 1. 5, and only local administration was used. Infection,hyphema,cornea injury,burns and other complications were not seen in all the patients. Conclusions MLT is effective and safety for OAG and OHT patients,and reduce the use of glaucoma drugs.

8.
Journal of the Korean Ophthalmological Society ; : 1166-1172, 2018.
Article in Korean | WPRIM | ID: wpr-738499

ABSTRACT

PURPOSE: To investigate the efficacy, and identify predictors of success of selective laser trabeculoplasty (SLT) in open-angle glaucoma (OAG) patients after adjusting for intraocular pressure (IOP) changes in the untreated fellow eye. METHODS: This retrospective chart review included 52 eyes of 52 OAG patients who underwent SLT in one eye and were followed-up for at least 1 year after the procedure. The IOP was measured before the treatment, at 1, 2, and 3 months posttreatment, and every 3 months thereafter. To account for the possible influence of IOP fluctuations on laser outcomes, post-laser IOP values of the treated eye of each patient were also analyzed, after adjusting for IOP changes in the untreated fellow eye. Success was defined as an IOP decrease ≥20% of the pretreatment IOP. The success rate was determined based on Kaplan-Meier survival analysis and factors predictive of success were analyzed using the Cox proportional hazard model. RESULTS: The mean pretreatment IOP was 23.17 ± 6.96 mmHg. The mean IOP reduction was 5.59 ± 4.78 mmHg (29.7%) and the success rate was 65.4% at 1 year. The adjusted mean IOP reduction was 4.70 ± 4.67 mmHg (23.9%) and the adjusted success rate was 53.9%. Pretreatment IOP was associated with SLT success; the higher the pretreatment IOP, the greater the post-laser IOP reduction (p = 0.025). Age and mean deviation index did not show a significant association with SLT success (p = 0.066 and p = 0.464, respectively). CONCLUSIONS: SLT is a safe and effective alternative method of IOP reduction in OAG patients. Herein, pretreatment IOP was the only factor significantly associated with SLT success. IOP fluctuations of the untreated eye should be considered for a better understanding of the impact of treatment.


Subject(s)
Humans , Glaucoma, Open-Angle , Intraocular Pressure , Methods , Proportional Hazards Models , Retrospective Studies , Shiga Toxin 1 , Trabeculectomy
9.
Chinese Journal of Postgraduates of Medicine ; (36): 1072-1075, 2017.
Article in Chinese | WPRIM | ID: wpr-666229

ABSTRACT

Objective To evaluate the efficacy of selective laser trabeculoplasty (SLT) as treatments of secondary glaucoma after intravitreal silicone oil injection. Methods Forty-five cases(45 eyes) of silicone oil glaucoma (SOG) from June 2014 to April 2016 were enrolled and divided into two groups according random digits table. The SLT treatment group had 21 cases (21 eyes), and drug treatment group had 23 cases(23 eyes).Intraocular pressure(IOP)changes were recorded 1 d, 1 week, 3 weeks, 1 month, 2 months, 3 months,4 months,5 months and 6 months after treatment.Results The decrease of IOP in SLT group was (11.47 ± 2.23), (11.27 ± 2.59), (10.43 ± 2.55), (11.93 ± 2.71), (13.75 ± 2.57),(13.93 ± 2.65),(10.45 ± 2.53)and(12.73 ±2.86)mmHg(1 mmHg=0.133 kPa).IOP of the control group decreased respectively (7.53 ± 3.29), (9.57 ± 3.49), (8.78 ± 4.21), (8.74 ± 3.86), (6.12 ± 4.41),(7.84 ± 3.26),(8.84 ± 4.25),(8.24 ± 3.56)mmHg.There was significant difference between the two groups 1 week, 1 month, 2 months, 3 months,4 months,5 months and 6 months after treatment (t = 4.17, 1.38, 2.89, 6.32, 3.89, 5.32, 5.19, P < 0.05 or < 0.01). Conclusions SLT is a safe and effective option for the treatment of patients with SOG.

10.
Recent Advances in Ophthalmology ; (6): 856-859, 2017.
Article in Chinese | WPRIM | ID: wpr-607160

ABSTRACT

Objective To compare the efficacy of selective laser trabeculoplasty (SLT) on the intraocular pressure (IOP) reduction in the treatment of ocular hypertension (OHT),early and moderate primary open angle glaucoma (POAG).Methods Non-randomized controlled study was conducted in 120 patients (120 eyes),who were divided into 3 groups according to the patients' condition,including OHT group with 40 eyes of 40 patients,early-stage POAG group (40 eyes of 40 patients) and medium-stage POAG group (40 eyes of 40 patients),aged rang from 16 to 79 years.SLT was performed on the 360° trabecular meshwork using 532 nm frequency-double Q-switched Nd:YAG laser (Selecta duet),with the pulse of 3 ns and spot diameter of 400 nm.The initial energy was 0.6 m J,which decreased at 0.1 mJ interval till champagne bubble appeared.The following-up was postoperative 1 day,1 week,1 month,3 months and 6 months,respectively,and changes in IOP before and after SLT was recorded and analyzed statistically.Resuits Postoperative IOP at different time points was significantly lower than that of preoperation in the three groups,with significant difference (all P < 0.05).There was also significant difference in IOP of the each group at different time points after the operation (all P < 0.05).The preoperative baseline IOP of OHT group,early-stage POAG group and medium-stage POAG group was (25.95 ± 1.80) nmHg (1 kPa =7.5 mmHg),(24.66 ± 1.55) mmHg and (25.62 ± 2.67) mmHg,respectively,approaching significant difference (P <0.05).After eliminating the influence of baseline IOP,intergroup differences of postoperative IOP at each time point in the three groups were statistically significant (all P < 0.05),and intragroup differences were also significant (all P < 0.05).When compared with corrected baseline IOP,the reduction of IOP was the largest in OHT group after SLT,followed by the early-stage POAG group,and the lowest was in the medium-stage POAG group.Conclusion SLT has a good effect on IOP reduction for OHT and POAG,and the treatment effect of SLT declines successively according to the severity of POAG.

11.
Journal of the Korean Ophthalmological Society ; : 828-835, 2017.
Article in Korean | WPRIM | ID: wpr-65567

ABSTRACT

PURPOSE: To determine the effect of intraocular pressure (IOP) reduction of selective laser trabeculoplasty (SLT) on medically uncontrolled open-angle glaucoma (OAG) and the factors associated with the treatment result. METHODS: Forty-seven eyes of 47 OAG patients were enrolled for 180° SLT or 360° SLT, all under maximal tolerated medical therapy and with IOP above their target pressure. All patients were followed-up for at least 1 year after the procedure. Treatment success was defined as IOP reduction ≥20% from baseline at 12 months after SLT treatment without additional anti-glaucomatous intervention. RESULTS: The treatment success rate was 65.96%. Baseline IOP was 23.84 ± 4.52 mmHg in the success group and 21.44 ± 2.97 mmHg in the failure group (p = 0.035). Significant mean IOP reduction was observed at 6, 9, and 12 month follow-ups (p = 0.001 at 6 months; 0.041 at 9 months, and <0.001 at 12 months). The success rate did not vary significantly by sex (p = 0.362), age (p = 0.081), history of cataract surgery (p = 0.470), number of medications (p = 0.857), duration of medication (p = 0.613), or angular degree of SLT treatment (180° vs. 360°) (p = 0.137). There was a positive correlation between mean baseline IOP and mean reduction of IOP from baseline in the success group (p < 0.001, r = 0.861), while there was no such correlation in the failure group (p = 0.272, r = −2.921). CONCLUSIONS: SLT was an effective treatment for IOP reduction until 12 months in medically uncontrolled OAG patients. A greater amount of IOP reduction is expected in patients with higher baseline IOP in the success group.


Subject(s)
Humans , Cataract , Follow-Up Studies , Glaucoma, Open-Angle , Intraocular Pressure , Trabeculectomy
12.
Indian J Ophthalmol ; 2016 Aug; 64(8): 568-571
Article in English | IMSEAR | ID: sea-179407

ABSTRACT

Purpose: To compare the results of conventional 1064 nm neodymium‑doped yttrium‑aluminum garnet laser goniopuncture (Nd:YAG‑GP) and selective 532 nm Nd:YAG laser (selective laser trabeculoplasty [SLT]) gonioreconditioning (GR) on trabeculo‑Descemet’s membrane in eyes resistant to viscocanalostomy surgery. Methods: Thirty‑eight eyes of 35 patients who underwent laser procedure after successful viscocanalostomy surgery were included in the study. When postoperative intraocular pressure (IOP) was above the individual target, the eyes were scheduled for laser procedure. Nineteen eyes underwent 532 nm SLT‑GR (Group 1), and the remaining 19 eyes underwent conventional 1064 nm Nd:YAG‑GP (Group 2). IOPs before and after laser (1 week, 1 month, 3 months, 6 months, 1 year, and last visit), follow‑up periods, number of glaucoma medications, and complications were recorded for both groups. Results: Mean times from surgery to laser procedures were 17.3 ± 9.6 months in Group 1 and 13.0 ± 11.4 months in Group 2. Mean IOPs before laser procedures were 21.2 ± 1.7 mmHg in Group 1 and 22.8 ± 1.9 mmHg in Group 2 (P = 0.454). Postlaser IOP measurements of Group 1 were 12.1 ± 3.4 mmHg and 13.8 ± 1.7 mmHg in the 1st week and last visit, respectively; in Group 2, these measurements were 13.6 ± 3.7 mmHg and 14.9 ± 4.8 mmHg, respectively. There were statistically significant differences (P < 0.001) in IOP reduction at all visits in both groups; the results of the two groups were similar (P > 0.05). Mean follow‑up was 16.6 ± 6.4 months after SLT‑GR and 18.9 ± 11.2 months after Nd:YAG‑GP. Conclusions: While conventional Nd:YAG‑GP and SLT‑GR, a novel procedure, are both effective choices in eyes resistant to viscocanalostomy, there are fewer complications with SLT‑GR. SLT‑GR can be an alternative to conventional Nd:YAG‑GP.

13.
Chinese Journal of Experimental Ophthalmology ; (12): 654-657, 2016.
Article in Chinese | WPRIM | ID: wpr-637960

ABSTRACT

Glaucoma is an irreversible blinding disease.The aim of glaucoma therapy is to lower the intraocular pressure (IOP),and then slow down glaucoma progression.Currently,this goal can be achieved by medication,laser treatment and surgery.Selective laser trabeculoplasty (SLT) involves using a 532 nm wave length Nd:YAG laser selectively target cells of the trabecular meshwork without causing thermal or collateral damage to the surroundings structures.The exact mechanism by which SLT lowers IOP remains unknown.It has become gradually one of the most preferred methods for the treatment of open angle glaucoma.SLT seems to have a similar IOP lowering effect with argon trabeculoplasty or monotherapy of topical prostaglandin medication.Mean IOP reduction after SLT was 3.8-8.0 mmHg in 6 months to 1 year.The long-term effect of SLT in the treatment of open angle glaucoma remains to be further studied.The relationship between the range of SLT treatment and its therapeutic effect has not been recognized.SLT is efficacious and safe,also has repeatable and less adverse effects.It can be used as an efficacious primary,adjunctive and replacement therapy for treating open angle glaucoma.In this paper,we reviewed the effects of SLT as an initial and repeat treatment,also the factors that could affect therapeutic effects.

14.
Journal of the Korean Ophthalmological Society ; : 1415-1421, 2016.
Article in Korean | WPRIM | ID: wpr-32969

ABSTRACT

PURPOSE: To compare the efficacy of selective laser trabeculoplasty (SLT) in patients treated with either latanoprost or dorzolamide/timolol fixed combination (DTFC) for primary open-angle glaucoma. METHODS: This retrospective study included 92 consecutive patients who underwent a 180-degree SLT for the first time. The subjects divided into two groups:patients who received latanoprost (n = 63) or DTFC (n = 29) before and after SLT. The main outcome measure was intraocular pressure (IOP) decrease over five years after SLT. The mean IOP change, mean percentage of IOP reduction, and success rates were compared between the patients treated with latanoprost and the patients treated with DTFC. Success was defined as an IOP decrease ≥ 3 mm Hg or IOP reduction ≥ 20% without additional medications, laser surgery, or glaucoma surgery. RESULTS: At the postoperative one-year follow-up, the mean IOP was 15.7 ± 2.2 mm Hg in the latanoprost group and, 16.2 ± 2.4 mm Hg in the DTFC group. At the postoperative five-year follow-up, the mean IOP was 15.1 ± 2.5 mm Hg in the latanoprost group and, 14.6 ± 1.7 mm Hg in the DTFC group. There were no statistically significant differences in IOP change, percentage IOP reduction, or success rate between the groups at each time point after the SLT (p > 0.05). CONCLUSIONS: Selective laser trabeculoplasty showed a reasonable efficacy in lowering the IOP over a five-year follow-up period. There were no significant differences in IOP lowering effect or success rate between the patients treated with latanoprost or DTFC.


Subject(s)
Humans , Follow-Up Studies , Glaucoma , Glaucoma, Open-Angle , Intraocular Pressure , Laser Therapy , Outcome Assessment, Health Care , Retrospective Studies , Trabeculectomy
15.
Journal of the Korean Ophthalmological Society ; : 1489-1492, 2016.
Article in Korean | WPRIM | ID: wpr-32957

ABSTRACT

PURPOSE: To report a case of hyphema after selective laser trabeculoplasty (SLT) in a patient with pseudoexfoliative glaucoma. CASE SUMMARY: A 77-year-old female was referred for elevation of intraocular pressure (IOP). Previously, she had been diagnosed with pseudoexfoliative glaucoma in the right eye and was using topical IOP-lowering agents. The best corrected visual acuity was 20/100 in the right eye and 20/40 in the left eye. IOP, measured with Goldmann applanation tonometer, was 32 mm Hg in the right eye and 20 mm Hg in the left eye. Gonioscopy revealed open-angle glaucoma with +2 trabecular meshwork pigmentation but without peripheral anterior synechiae or neovascularization. SLT was performed in the right eye. Two days later, the patient had sudden onset of blurred vision and pain in the right eye. Visual acuity was limited to light perception, and IOP was 34 mm Hg in the right eye. Slit-lamp examination revealed 1.1 mm hyphema with 4+ red blood cell count in the anterior chamber. Three weeks after the SLT, hyphema in the right eye disappeared, but IOP was measured to be 42 mm Hg. The patient underwent trabeculectomy in the right eye. CONCLUSIONS: SLT is an effective means of lowering IOP with low risk of complications. However, hyphema can rarely occur after SLT and can affect the outcome of the treatment.


Subject(s)
Aged , Female , Humans , Anterior Chamber , Erythrocyte Count , Glaucoma , Glaucoma, Open-Angle , Gonioscopy , Hyphema , Intraocular Pressure , Pigmentation , Shiga Toxin 1 , Trabecular Meshwork , Trabeculectomy , Visual Acuity
16.
Journal of the Korean Ophthalmological Society ; : 911-916, 2015.
Article in Korean | WPRIM | ID: wpr-73389

ABSTRACT

PURPOSE: To compare the efficacy of selective laser trabeculoplasty (SLT) in phakic and pseudophakic eyes in primary open-angle glaucoma. METHODS: Charts of 55 phakic eyes and 24 pseudophakic eyes that underwent 360-degree SLT were retrospectively reviewed. Intraocular pressure (IOP) was measured before SLT and 1 week, 1, 3, 6, 9, 12, 18 and 24 months after SLT. Treatment success was defined as IOP reduction > or = 20% without additional medications, laser or glaucoma surgery. Mean IOP change, mean percentage of IOP reduction and success rates of phakic and pseudophakic eyes were compared. RESULTS: Mean percentage of IOP reduction after SLT at 1 week and 1, 3, 6, 9, 12, 18, and 24 months were 18.8%, 23.9%, 24.6%, 23.3%, 24.0%, 22.1%, 20.8%, and 17.9%, respectively, in the phakic group and 15.7%, 22.3%, 23.7%, 25.3%, 25.6%, 25.2%, 21.9%, and 19.3%, respectively, in the pseudophakic group. Success rates were 57.6 +/- 11.9% in the phakic group and 61.3 +/- 10.4% in the pseudophakic group. No statistically significant differences in IOP change, percentage of IOP reduction, and success rates were observed between the groups at each time point after SLT (p > 0.05). CONCLUSIONS: Application of 360-degree SLT appears an efficient treatment option for the management of phakic and pseudophakic open-angle glaucoma. Evaluating the success of SLT 1 month postoperatively may be premature.


Subject(s)
Cataract , Glaucoma , Glaucoma, Open-Angle , Intraocular Pressure , Retrospective Studies , Trabeculectomy
17.
Br J Med Med Res ; 2014 Feb; 4(4): 1008-1013
Article in English | IMSEAR | ID: sea-174985

ABSTRACT

Introduction: Selective laser trabeculoplasty (SLT) (Lumenis, Santa Clara, CA) was developed in 1999 as a means to lower IOP in patients with glaucoma. It is a relatively safe procedure. We report a rare side effect of anterior chamber shallowing with myopic following SLT. Case Presentation: A 48 year-old white female who underwent SLT OD developed a 4- diopter myopic shift and anterior chamber shallowing 1 week following SLT. Both the anterior chamber shallowing and the myopic shift resolved within 5 weeks. Conclusion: Anterior chamber shallowing and myopic shift following SLT is a rare side effect but is reversible. Physicians and patients should be aware of this potential side effect of SLT.

18.
Br J Med Med Res ; 2014 Jan; 4(1): 279-287
Article in English | IMSEAR | ID: sea-174893

ABSTRACT

Aims: Selective laser trabeculoplasty (SLT) (Lumenis, Santa Clara, CA) was developed in 1999 as a means to lower IOP in patients with glaucoma. It is a relatively safe procedure. We report a rare side effect of corneal opacity and stromal haze with corneal thinning and hyperopic shift following SLT. Presentation of Case: Case report. Results: A 50 year-old Asian male who underwent SLT OD developed mild corneal edema and slightly elevated intraocular pressure (IOP) one day after procedure. He was prescribed anti-inflammatory drops. One week afterwards, he developed a small corneal abrasion centrally. He was given topical antibiotics and asked to continue antiinflammatory drops. On postoperative day 8, his corneal abrasion healed, but he developed stromal corneal haze. Topical steroids were begun. By postoperative week #2, his visual acuity and stromal haze had improved. His corneal thickness decreased from 600 μms to 468 μms. After one year, he had almost complete resolution of his corneal pathology but had residual corneal thinning and flattening. Discussion: Corneal stromal haze following SLT is a rare side effect. This can result in corneal scarring with corneal thinning and a hyperopic shift due to corneal flattening. Physicians and patients should be aware of this potentially vision threatening side effect. Conclusion: More studies are needed to identify risk factors for the development of corneal pathology following selective laser trabeculoplasty.

19.
Chinese Journal of Experimental Ophthalmology ; (12): 178-181, 2014.
Article in Chinese | WPRIM | ID: wpr-636416

ABSTRACT

Glaucoma is the second leading cause of irreversible blindness worldwide.The treatment of glaucomatous eyes is a long-term procedure.Laser treatment is becoming one of the three major methods to lower intraocular pressure (IOP) of glaucomatous patients.Selective laser trabeculoplasty (SLT) mainly targets to the pigment cells on the trabecular meshwork and makes it easier for fluid to flow out of the front part of the eye,decreasing pressure in the eye.But,the actual mechanism of this surgery is below understood now.Compared with other laser therapy,SLT uses a lower-level laser to open the drainage angle of the eye,and therefore cause rare or slight complication,so it is thought to be a repeatable therapy to the patients who needs further treatment.The principle,clinical application,efficacy,safety and study progress about SLT for glaucomatous eyes are reviewed.

20.
Chinese Journal of Experimental Ophthalmology ; (12): 107-113, 2014.
Article in Chinese | WPRIM | ID: wpr-636408

ABSTRACT

Background Selective laser trabeculoplasty (SLT) plays lowing-intraocular pressure (IOP)effect by irradiating pigmented trabecular cells selectively using 532 nm Nd:YAG laser.However,its affect pattern is not fully known.Objective This study was to establish a human trabecular cells (HTCs) model of SLT effect,and to observe the morphological changes of HTCs after they were exposed to different energies of SLT.Methods Immortalized HTCs were incubated in DMEM/F12 with pigmental granules for 16 hours (overnight) to prepare pigmented trabecular cells.The cells were irradiated with modified laser lens with the spot of 400 μm and emitting duration of 3 ns.The energy scale of 0.2 mJ was set for standardized energy and 0.1 mJ was used as the low energy.The morphology and ultrastructure of the cells were examined under the light microscope and transmission electron microscope 1 hour,4,8,12,24 hours after irradiation.Trypan blue staining and TUNEL fluorescence staining were used to evaluate the death and apoptosis of the cells after laser irradiation.Results The brown pigment particles were seen in cytoplasm around nuclei of trabecular cells after cultured for 16 hours.After laser irradiation,there was no obvious change in the shape of nonpigmented trabcular cells,but a 400 μm spot was found in the pigmented trabecular cells under the light microscope,and the pigmented particles released as the cell disruption.After 0.2 mJ laser irradiation,cell loss zone was seen at the center of the laser spot,and the positive cells for trypan blue and TUNEL staining were found;while the abnormal manifestations were slight after the 0.1 mJ irradiation.With the lapse of the time,the number of positive staining cells was gradually decreased.Twenty-four hours after laser irradiation,proliferative trabecular cells emerged and migrated to the center area of laser spot.Statistical analysis showed that the numbers of the positive cells for trypan blue and TUNEL staining were significantly reduced in the lower energy group in comparison with the standardized energy group at various time points (all at P<0.001),and those of both energy groups were gradually reduced with lapse of time with the significant differences between any two time points (all at P<0.01).Conclusions An in vitro laser effect model of HTCs can be established by exposing pigmented HTCs to SLT laser.After exposed to SLT,the gasification,necrosis-like death,apoptosis-like change appear at the laser center.The laser destroyed cells can be replaced by proliferative cells with the lapse of time.Low-energy laser irradiation cause a similar morphological change of the cells to high-energy irradiation,but the number of abnormal cells is much less.

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