Five-Year Long-Term Follow-Up of Selective Laser Trabeculoplasty in Open-Angle Glaucoma

Abstract

Purpose Selective laser trabeculoplasty (SLT) is known as a safe laser therapy for an effective reduction in intraocular pressure (IOP). The aim of this study was to examine the therapeutic success of SLT in open-angle glaucoma (OAG) patients with a long-term follow-up of 5 years.

Methods Forty-six eyes of forty OAG patients, some with previous intraocular surgery, underwent SLT (24 males, 16 females). Therapeutic success was categorized as: category (I) – IOP reduction ≤ 21 mmHg and > 20% compared to baseline IOP with additional glaucoma medication; category (II) – IOP reduction ≤ 18 mmHg and > 30% compared to baseline IOP with additional glaucoma medication; category (III) – IOP reduction ≤ 18 mmHg without any additional glaucoma medication at all follow-ups. Therapeutic failure was defined as the necessity of any further glaucoma surgery (IV).

Results (1) SLT was well tolerated in all eyes, and no severe side effects or complications were recorded. (2) After 1-year follow-up, therapeutic success was 27% (I), 30% (II), and 3% (III). The therapeutic failure rate was 40% (IV). (3) After 2 years follow-up, therapeutic success was 7% (I), 10% (II), and 0% (III). The therapeutic failure rate was 83% (IV). (4) After 3 years follow-up, the therapeutic failure rate increased up to 100% (IV).

Conclusion SLT seemed to be effective in lowering IOP in the first year in the present cohort, however, the long-term effect is low and additional local therapy or surgical interventions are necessary.

Zusammenfassung

Hintergrund Die selektive Lasertrabekuloplastik (SLT) ist als sichere Lasertherapie zur effektiven Senkung des Augeninnendrucks (IOD) bekannt. Ziel dieser Studie war es, den therapeutischen Erfolg der SLT bei Patienten mit Offenwinkelglaukom (OWG) in einem Langzeit-Follow-up von 5 Jahren zu untersuchen.

Methoden 46 Augen von 40 OWG-Patienten mit teilweise vorheriger intraokularer Operation wurden einer SLT unterzogen (24 Männer, 16 Frauen). Der Therapieerfolg wurde wie folgt kategorisiert: Kategorie (I) – IOD-Senkung ≤ 21 mmHg und > 20% im Vergleich zum Ausgangsdruck mit zusätzlicher Glaukommedikation; Kategorie (II) – IOD-Senkung ≤ 18 mmHg und > 30% im Vergleich zum Ausgangsdruck mit zusätzlicher Glaukommedikation; Kategorie (III) – IOD-Senkung ≤ 18 mmHg ohne zusätzliche Glaukommedikation bei allen Nachuntersuchungen. Als Therapieversagen wurde die Notwendigkeit einer weiteren Glaukomoperation definiert (IV).

Ergebnisse (1) Die SLT wurde in allen Augen gut vertragen und es wurden keine schweren Nebenwirkungen oder Komplikationen festgestellt. (2) Nach 1 Jahr Nachbeobachtung betrug der Therapieerfolg 27% (I), 30% (II) und 3% (III). Die Rate der Therapieversager lag bei 40% (IV). (3) Nach 2 Jahren Nachbeobachtung betrug der Therapieerfolg 7% (I), 10% (II) und 0% (III). Die Rate der Therapieversager lag bei 83% (IV). (4) Die Rate der Therapieversager stieg auf 100% nach 3 Jahren Nachbeobachtung (IV).

Schlussfolgerung Die SLT scheint bei der Senkung des IOD im 1. Jahr in der vorliegenden Kohorte wirksam zu sein, der Langzeiteffekt ist jedoch gering und es sind zusätzliche lokale Therapien oder chirurgische Eingriffe erforderlich.

Key words

selective laser trabeculoplasty - SLT - intraocular pressure - IOP - glaucoma

Schlüsselwörter

selektive Lasertrabekuloplastik - SLT - IOD - Glaukom

Publication History

Received: 12 June 2021

Accepted: 05 October 2021

Article published online:
17 December 2021

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