Influence of Selective Laser Trabeculoplasty (SLT) on combined clear cornea phacoemulsification and Trabectome outcomes

• Published in: Graefe's archive for clinical and experimental ophthalmology Vol. 252; no. 4; pp. 627 - 631
• Main Authors: Klamann, Matthias K. J., Gonnermann, Johannes, Maier, Anna-Karina B., Bertelmann, Eckart, Joussen, Antonia M., Torun, Necip
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-04-2014; Springer Nature B.V
• Subjects: Aged; Cohort Studies; Cornea - surgery; Exfoliation Syndrome - surgery; Female; Follow-Up Studies; Glaucoma; Glaucoma, Open-Angle - surgery; Humans; Intraocular Pressure; Laser Therapy; Lasers, Solid-State - therapeutic use; Male; Medicine; Medicine & Public Health; Middle Aged; Ophthalmology; Phacoemulsification; Retrospective Studies; Tonometry, Ocular; Trabeculectomy; Treatment Outcome; Pigmentary glaucoma; Selective Laser Trabeculoplasty (SLT); Ab interno trabeculectomy (Trabectome); Pseudoexfoliation glaucoma; Primary open angle glaucoma
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-014-2569-7

Background
In this retrospective comparative cohort outcome study, the influence of Selective Laser Trabeculoplasty (SLT) on combined clear cornea phacoemulsification and ab interno trabeculectomy (Trabectome) outcomes in Primary Open Angle Glaucoma (POAG), Pseudoexfoliation Glaucoma (PEX), and Pigmentary Glaucoma (PG) was examined.
Methods
Combined clear cornea phacoemulsification and Trabectome were performed in 27 consecutive patients with POAG, in 27 patients with PEX, and in 20 patients with PG. Each group was divided into two subgroups including patients without SLT treatment prior to surgery and patients who had insufficient response to 360° SLT treatment three months prior to surgery.
Results
In the SLT group, mean IOP at six months measured 13.33 ± 2.08 mmHg with an average decrease of 30 % from preoperative IOP in the POAG group, 12.10 ± 1.40 mmHg with an average decrease of 46 % in the PEX group, and 11.83 ± 2.21 mmHg with an average decrease of 38 % in the PG group. In eyes without previous SLT, mean IOP sixt 6 months measured 11.00 ± 1.73 mmHg with an average decrease of 38 % from preoperative IOP in the POAG group, 15.50 ± 1.41 mmHg with an average decrease of 35 % in the PEX group, and 15.67 ± 2.91 mmHg with an average decrease of 36 % in the PG group, respectively.
Conclusions
Prior SLT treatment seems not to negatively influence combined clear cornea phacoemulsification and Trabectome outcomes in glaucoma patients. However, SLT treatment may even have an additive effect on following combined Trabectome outcomes in patients with PEX and PG.