Selective laser trabeculoplasty for primary angle closure with persistently elevated intraocular pressure after iridotomy.
OBJECTIVE
To determine whether selective laser trabeculoplasty (SLT) can lower intraocular pressure (IOP) in eyes with chronic primary angle closure, elevated IOP, and a patent iridotomy.


METHODS
Patients with chronic angle closure who had underwent iridotomy, had an IOP greater than 21 mm Hg and a gonioscopically visible pigmented trabecular meshwork for at least 90 degrees were enrolled. SLT was applied to open angle segments. Duration of follow-up was 6 months.


RESULTS
Sixty eyes of 60 patients were enrolled. The mean baseline IOP was 24.6+/-2.5 mm Hg. At 6 months, IOP reduction of > or =3 mm Hg or 4 mm Hg was measured in 82% and 72% of eyes, respectively, and IOP reduction of > or =20% or 30% was measured in 54% and 24% of eyes, respectively. When only eyes that were treated with the same number or fewer medications were considered, these IOP reductions were measured in 67%, 58%, 43%, and 15%, respectively. During the study period 1 eye (1.7%) required trabeculectomy owing to IOP elevation shortly after the SLT. There were no other significant complications attributable to SLT.


CONCLUSIONS
SLT seems to be a safe and effective method of reducing IOP in many eyes with primary angle closure and a patent iridotomy in which there is a sufficient extent of visible trabecular meshwork.
Ho
Ching Lin
CL
Department of Ophthalmology, Singapore National Eye Center, Tan Tock Seng Hospital, Singapore.
Lai
Jimmy S M
JS
Aquino
Mario V
MV
Rojanapongpun
Prin
P
Wong
Hon Tym
HT
Aquino
Ma Cecilia
MC
Gerber
Yariv
Y
Belkin
Michael
M
Barkana
Yaniv
Y
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D015812:Glaucoma, Angle-Closure / Q000601:surgery*; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure; D032801:Iridectomy; D007498:Iris / Q000601:surgery; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000601:surgery; D012086:Reoperation; D014129:Trabecular Meshwork / Q000601:surgery; D014130:Trabeculectomy / Q000379:methods*