[Selective laser trabeculoplasty--new possibilities in glaucoma treatment].
The authors introduced into the clinical practice their own modification of the treatment by means of selective laser trabeculoplasty (SLT) in glaucoma patients. The SLT spots are burn in the extent of 270 degrees circumferentially in the anterior chamber angle (1.0 mJ, 80 spots, 400 microm). In the first group of 569 eyes with primary open angle glaucoma (POAG), followed up retrospectively and irregularly, at the control visit one year after the treatment, it was in 357 eyes possible, due to favorable decrease of the intraocular pressure (IOP), to decrease the medication from combined therapy to monotherapy, or to decrease the frequency of the application of antiglaucomatics, or to decrease their concentration. In other 197 eyes, the IOP was stabilized, but it was not possible to change the therapy, and in 15 cases, due to dissatisfactory effect of the treatment, the trabeculectomy was necessary. In the second group of POAG patients (133 eyes) followed up prospectively 1, 3, 6 and 12 months after the treatment, the decrease of the IOP from 21.1 +/- 4.5 mm Hg to 17.8 +/- 3.2 mm Hg after one month (P <0.0001), to 18.6 +/- 3.6 mm Hg after 3 months, to 17.8 +/- 3.1 mm Hg after 6 moths, and to 17.7 +/- 2.8 mm Hg after 12 moths was established. Good effect to the decrease the IOP was proved in pseudoexfoliative glaucoma as well. In the pigmentary glaucoma, the decrease of the IOP was found to be temporary, and on the contrary, in two cases, shortly after the SLT, considerable elevation of the IOP was found with the necessity to perform the trabeculectomy. The SLT may be used as the primary treatment in newly diagnosed POAG with advance, as well as possibility to terminate the treatment in cases when the glaucoma diagnosis is dubious.
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Ocní klinika 1. lékarské fakulty Univerzity Karlovy a Ustrední vojenské nemocnice, Praha. petr.vyborny@uvn.cz
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D053685:Laser Therapy; D008875:Middle Aged; D014130:Trabeculectomy