[Laser surgery for glaucoma: excimer-laser trabeculotomy].
BACKGROUND
Excimer-laser trabeculotomy (ELT) is a new, minimally invasive surgical procedure for the treatment of open-angle glaucoma that can easily be combined with cataract surgery. We herein report our experience with ELT as a stand-alone procedure and ELT plus cataract surgery.


METHODS
A total of 135 patients with open-angle glaucoma (n = 128) or ocular hypertension (n = 7) (M : F = 49 : 86, mean age 69.7 +/- 1.2 years) were included in this study. Patients were divided into 2 groups: a) ELT as a stand-alone procedure (n = 75), b) combined cataract and ELT procedure (n = 60). Both groups were further divided into 2 subgroups: 1) Preoperative IOP > 22 mmHg, 2) Preoperative IOP < or = 22 mmHg. Kaplan-Meier survival curves were calculated. Success criterion was 20 % decrease of IOP and IOP < or = 21 mmHg and postoperative IOP-lowering medication < or = preoperative IOP-lowering medication. Follow-up time was 1 year.


RESULTS
Group a) ELT, 1) preoperative IOP > 22 mmHg, 2) preoperative IOP < or = 22 mmHg: Kaplan-Meier survival curves showed a success rate of 57 % in subgroup 1 and of 41 % in subgroup 2. Group b) Combined cataract and ELT procedure, 1) preoperative IOP > 22 mmHg, 2) Preoperative IOP < or = 22 mmHg: success rate was 91 % in subgroup 1 and 52 % in subgroup 2.


CONCLUSIONS
ELT is a promising IOP-lowering technique both as a stand-alone procedure and in combination with cataract surgery. It is especially suitable for patients with high preoperative IOP levels.
Pache
M
M
Universitäts-Augenklinik Freiburg, Freiburg. Mona.Pache@uniklinik-freiburg.de
Wilmsmeyer
S
S
Funk
J
J
D000368:Aged; D002387:Cataract Extraction / Q000379:methods*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000601:surgery*; D006801:Humans; D054018:Lasers, Excimer; D008297:Male; D018903:Photorefractive Keratectomy / Q000379:methods*; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology / Q000517:prevention & control*