Gracner T.

General Hospital Maribor, Department of Ophthalmology, Ljubljanska 5, 2000 Maribor, Slovenia

Objective: To investigate the efficacy of selective laser trabeculoplasty (SLT) to lower intraocular pressure (IOP) in the treatment of uncontrolled primary open-angle glaucoma (POAG) in a prospective clinical study. SLT represents a new method in the treatment of POAG.
Methods: 82 eyes with uncontrolled POAG were treated with a frequencydoubled, Q-switched Nd:YAG laser (532 nm). A total of approximately 50 nonoverlapping spots were placed over 180 degrees of the trabecular meshwork at energy levels ranging from 0.40-0.96 mJ per pulse. After SLT, the eyes were maintained with the identical hypotensive medical therapy as that before treatment. IOP was estimated before and then 1 day, 7 days, 1, 3, 6, 12, 18, 24 months after treatment. Eyes with a 3 mmHg or greater decrease in IOP from baseline were defined as responders.
Results: The mean follow-up time was 18.4 months (SD 5.5). The mean pretreatment IOP was 22.21 mmHg (SD 2.4). At 1 month of follow-up the mean IOP reduction was 4.89 mmHg (SD 2.4) or 22.0% and at 3 months 5.20 mmHg (SD 2.5) or 23.4% for 82 eyes. At 6 months the mean IOP reduction was 5.13 mmHg (SD 2.5) or 22.9% for 79 eyes. At 12 months of follow-up the mean IOP reduction was 5.29 mmHg (SD 2.2) or 23.5% for 73 eyes. At 18 months the mean IOP reduction was 6.28 mmHg (SD 2.2) or 27.7% for 53 eyes. At the end of 24 months of follow-up the mean IOP reduction was 6.48 mmHg (SD 2.5) or 28.4% for 33 eyes. 13 eyes failed to respond to SLT (3 eyes after 6 months, 6 eyes after 12 months, 3 eyes after 18 months and 1 eye after 24 months), so 84.2% of eyes were responders in the study period.
Conclusion: SLT is a new effective method to lower IOP in the treatment of POAG.

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