Abstract
Background
To study the role of selective laser trabeculoplasty (SLT) in intraocular pressure (IOP) reduction in post-laser iridotomy primary angle-closure disease patients with inadequately controlled IOP.
Methods
In this prospective cross-sectional study, 34 patients with primary angle-closure disease with post-laser iridotomy open angles up to at least 180° were recruited. Following SLT, patients were examined at 1 day, 1 week, 1 and 3 months, 6 months and 1 year post SLT.
Results
Data of 34 patients (34 eyes; 8 males and 26 females), with a mean age of 57.80 ± 6.44 years, were analysed. The reduction in IOP at each follow-up visit was significant (p < 0.001). The maximum reduction in IOP was noticed on post-laser day 1 and the least reduction was noticed 1 week post laser. Post-SLT range of IOP reduction varied from 9 to 46% at 1 year, which indicates the variability of a response to SLT. Mean IOP in both primary angle closure (PAC) and primary angle closure glaucoma (PACG) groups was comparable at all visits except at post-SLT week 1 when IOP in the PACG group was significantly higher than that in the PAC group (p = 0.035). None of the patients complained of pain and/or discomfort or had any clinically significant anterior segment inflammation on any of the follow-up visits. None of the patients underwent repeat SLT or surgery. The mean pre-SLT and post-SLT visual field index at 1-year follow-up was 95.47 ± 3.58 and 95.90 ± 4.13, respectively, which was not significant (p = 0.84).
Conclusions
High baseline IOP significantly correlated with reduction in IOP. Our results suggest that SLT is a safe, cost-effective modality for reducing IOP in primary angle-closure disease with patent laser iridotomy with a visible trabecular meshwork.
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Change history
10 July 2020
A Correction to this paper has been published: https://doi.org/10.1038/s41433-020-1047-1
References
Quigley HA. Glaucoma. Lancet. 2011;377:1367–77.
Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol. 2006;90:262–7.
Cheng J-W, Zong Y, Zeng Y-Y, Wei R-L. The prevalence of primary angle closure glaucoma in adult Asians: a systematic review and meta-analysis. Acott TS, ed. PLoS ONE. 2014;9:e103222.
Amoozgar B, Moghimi S, Han Y, Lin SC. An update on therapeutic modalities for the prevention of angle closure glaucoma. Curr Opin Ophthalmol. 2017 Mar;28(2):175–180.
Azuara-Blanco A, Burr J, Ramsay C, Cooper D, Foster PJ, Friedman DS, et al. Effectiveness of early lens extraction for the treatment of primary angle-closure glaucoma (EAGLE): a randomised controlled trial. Lancet. 2016;388:1389–97. https://doi.org/10.1016/S0140-6736(16)30956-4.
Peng PH, Nguyen H, Lin HS, Nguyen N, Lin S. Long-term outcomes of laser iridotomy in Vietnamese patients with primary angle closure. Br J Ophthalmol. 2011;95:1207–11.
Quek DT, Ong GT, Perera SA, Lamoureux EL, Aung T. Persistence of patients receiving topical glaucoma monotherapy in an Asian population. Arch Ophthalmol. 2011;129:643–8.
De Keyser M, De Belder M, De Belder S, De Groot V. Where does selective laser trabeculoplasty stand now? A review. Eye Vis (Lond). 2016;3:10.
Olthoff CM, Schouten JS, van de Borne BW, Webers CA. Noncompliance with ocular hypotensive treatment in patients with glaucoma or ocular hypertension an evidence-based review. Ophthalmology. 2005;112:953–61.
Ho CL, Lai JS, Aquino MV, Rojanapongpun P, Wong HT, Aquino MC, et al. Selective laser trabeculoplasty for primary angle closure with persistently elevated intraocular pressure after iridotomy. J Glaucoma. 2009;18:563–6.
Narayanaswamy A, Leung CK, Istiantoro DV, Perera SA, Ho CL, Nongpiur ME, et al. Efficacy of selective laser trabeculoplasty in primary angle-closure glaucoma: a randomized clinical trial. JAMA Ophthalmol. 2015;133:206–12.
Ali Aljasim L, Owaidhah O, Edward DP. Selective laser trabeculoplasty in primary angle-closure glaucoma after laser peripheral iridotomy: a case–control study. J Glaucoma. 2016;25:e253–8.
Foster PJ, Buhrmann R, Quigley HA, Johnson GJ. The definition and classification of glaucoma in prevalence surveys. Br J Ophthalmol. 2002;86:238–4.
Hodapp E, Parrish RK II, Anderson DR. Clinical decisions in glaucoma. St. Louis, MO: Mosby Year Book Inc; 1993. p. 52–9.
Jabs DA, Nussenblatt RB, Rosenbaum JT. Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol. 2005;140:509–16.
South East Asia Glaucoma Interest Group. Appendix 6A. Gonioscopy. Asia Pacific Glaucoma Guidelines. 2nd ed. South East Asia Glaucoma Interest Group; Kugler Publications, Amsterdam, The Netherlands 2008.
Matos AG, Asrani SG, Paula JS. Feasibility of laser trabeculoplasty in angle closure glaucoma: a review of favorable histopathological findings in narrow angles. Clin Exp Ophthalmol. 2017;45:632–9.
Johnson PB, Katz LJ, Rhee DJ. Selective laser trabeculoplasty: predictive value of early intraocular pressure measurements for success at 3 months. Br J Ophthalmol. 2006;90:741–3.
McIlraith I, Strasfeld M, Colev G, Hutnik CM. Selective laser trabeculoplasty as initial and adjunctive treatment for open-angle glaucoma. J Glaucoma. 2006;15:124–30.
Kagan DB, Gorfinkel NS, Hutnik CM, Mechanisms of selective laser trabeculoplasty: a review. Clin Exp Ophthalmol. 2014;42:675–81.
Nagar M, Ogunyomade A, O’Brart DP, Howes F, Marshall J. A randomised, prospective study comparing selective laser trabeculoplasty with latanoprost for the control of intraocular pressure in ocular hypertension and open angle glaucoma. Br J Ophthalmol. 2005;89:1413–7.
Stein JD, Challa P. Mechanisms of action and efficacy of argon laser trabeculoplasty and selective laser trabeculoplasty. Curr Opin Ophthalmol. 2007;18:140–5.
Alvarado JA, Yeh RF, Franse-Carman L, Marcellino G, Brownstein MJ. Interactions between endothelia of the trabecular meshwork and of Schlemm’s canal: a new insight into the regulation of aqueous outflow in the eye. Trans Am Ophthalmol Soc. 2005;103:148–62. discussion 62–3
Leahy KE, White AJ, Selective laser trabeculoplasty: current perspectives. Clin Ophthalmol. 2015;9:833–41.
Martinez-de-la-Casa JM, Garcia-Feijoo J, Castillo A, et al. Selective vs argon laser trabeculoplasty: hypotensive efficacy, anterior chamber inflammation, and postoperative pain. Eye (Lond). 2004;18:498–502.
Latina MA, Sibayan SA, Shin DH, Noecker RJ, Marcellino G. Q-switched 532-nm Nd:YAG laser trabeculoplasty (selective laser trabeculoplasty): a multicenter, pilot, clinical study. Ophthalmology. 1998;105:2082–90. discussion 9–90
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Raj, S., Tigari, B., Faisal, T.T. et al. Efficacy of selective laser trabeculoplasty in primary angle closure disease. Eye 32, 1710–1716 (2018). https://doi.org/10.1038/s41433-018-0165-5
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DOI: https://doi.org/10.1038/s41433-018-0165-5
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