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J Glaucoma. 2017 Mar;26(3):201-207. doi: 10.1097/IJG.0000000000000464.

Transscleral Selective Laser Trabeculoplasty Without a Gonioscopy Lens.

Author information

1
*Department of Ophthalmology, Meir Medical Center, Kfar Saba §Department of Ophthalmology, Assaf Harofeh Medical Center †Sackler Faculty of Medicine, Tel Aviv University ‡The Ein Tal Medical Center, Tel-Aviv ∥Department of Ophthalmology, Goldschleger Eye Research Institute, Sheba Medical Center, Tel Hashomer, Israel.

Abstract

PURPOSE OF THE STUDY:

The purpose of the study was to investigate results of selective laser trabeculoplasty (SLT) performed directly on the sclera without a gonioscopy lens.

DESIGN:

Interventional case series, prospective, randomized, masked, controlled clinical trial.

METHODS:

Setting: Meir Medical Center, Kfar-Saba, Israel.

STUDY POPULATION:

Adults with uncontrolled primary open angle or pseudoexfoliation glaucoma randomized into 2 groups.

INTERVENTION:

The controls underwent conventional SLT with 100 spots delivered using a gonioscopy lens for 360 degrees of the trabecular meshwork. The study group underwent irradiation using the same parameters with the laser applications administered on the perilimbal sclera. Study visits: 1 hour, 1, 7, 30, 60, 180, and 365 days postprocedure.

MAIN OUTCOME MEASURES:

Intraocular pressure (IOP) and side effects.

RESULTS:

Thirty adults were randomized into 2 groups. The mean (±SD) pretreatment IOP was 20.21±3.19 mm Hg for the study group (n=14) and 21.14±2.98 mm Hg for the controls (n=14; P =0.43), dropping to 15.50±3.77 and 15.00±4.08 mm Hg (P =0.74) after 6 months and to 16.00±3.31 and 14.00±2.45 mm Hg (P =0.22) after 12 months. The average IOP reduction after 6 and 12 months was 23.4% and 20.83% for the study group and 27.1% and 33.77% for the controls (P=0.528). Success (a decrease of ≥15% at 6 months with no additional medications, laser, or glaucoma surgery) was achieved in 12 (85.7%) study patients and 9 (69.2%) controls (P=0.385). Complications were mild and transient (n=30), although significantly higher in the controls (n=15; P <0.0001).

CONCLUSIONS:

SLT applied directly to the perilimbal sclera may be as efficacious as the conventional procedure for 1 year.

PMID:
27636593
DOI:
10.1097/IJG.0000000000000464
[Indexed for MEDLINE]

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