title: Long-term follow-up of diode laser trabeculoplasty for primary open-angle glaucoma and ocular hypertension.
abstract: BACKGROUND
  Initial studies of laser trabeculoplasty using infrared energy (810 nm) emitted by diode semi-conductor lasers have been encouraging. A 2-year study of diode laser trabeculoplasty (DLT) in the control of primary open-angle glaucoma (POAG) and ocular hypertension has been completed.
  
  
  METHODS
  Patients with uncontrolled POAG or ocular hypertension were treated with DLT to one half of the trabecular meshwork using a trabeculoplasty lens. Spot size was 100 microns, exposure time was 0.2 second, and mean power was 1096 mW (+/- 46.5 mW). The desired endpoint was a mild blanching of the meshwork only.
  
  
  RESULTS
  Twenty-five eyes of 16 patients were treated. Mean intraocular pressure reduction was 9.24 mmHg (+/- 3.4 mmHg) at 6 weeks, 9.32 mmHg (+/- 3.6 mmHg) at 3 months, 9.34 mmHg (+/- 3.8 mmHg) at 6 months, 8.42 mmHg (+/- 2.62 mmHg) at 12 months, 8.14 mmHg (+/- 3.42 mmHg) at 18 months, and 7.9 mmHg (+/- 3.63 mmHg) at 24 months. No pressure peaks (> 5 mmHg) were recorded after therapy. Inflammation and discomfort were minimal after laser treatment. Of 16 eyes examined at 2 years, there were no peripheral anterior synechiae. During the course of the study, six eyes became uncontrolled, despite one session of DLT. Four eyes regained control with a further session of DLT, but two required trabeculectomy.
  
  
  CONCLUSIONS
  Diode laser trabeculoplasty is an effective form of therapy in POAG and ocular hypertension. Hypotensive effects and success rates are comparable with argon laser trabeculoplasty (ALT). Reduced inflammation after laser treatment may be due to reduced absorption of infrared energy by the melanin of the anterior segment. The portable nature of these lasers may allow for laser delivery in developing countries and remote situations.
authors.affiliation: Department of Ophthalmology, St Thomas' Hospital, London.
authors.forename: A P
authors.initials: AP
authors.lastname: Moriarty
authors.forename: J D
authors.initials: JD
authors.lastname: McHugh
authors.forename: T J
authors.initials: TJ
authors.lastname: Ffytche
authors.forename: J
authors.initials: J
authors.lastname: Marshall
authors.forename: A M
authors.initials: AM
authors.lastname: Hamilton
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D053685:Laser Therapy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis; D014130:Trabeculectomy / Q000379:methods*; D014792:Visual Acuity