title: Transscleral Selective Laser Trabeculoplasty Without a Gonioscopy Lens.
abstract: OBJECTIVE
  The purpose of the study was to investigate results of selective laser trabeculoplasty (SLT) performed directly on the sclera without a gonioscopy lens.
  
  
  METHODS
  Interventional case series, prospective, randomized, masked, controlled clinical trial.
  
  
  METHODS
  Setting: Meir Medical Center, Kfar-Saba, Israel.
  
  
  METHODS
  Adults with uncontrolled primary open angle or pseudoexfoliation glaucoma randomized into 2 groups.
  
  
  METHODS
  The controls underwent conventional SLT with 100 spots delivered using a gonioscopy lens for 360 degrees of the trabecular meshwork. The study group underwent irradiation using the same parameters with the laser applications administered on the perilimbal sclera. Study visits: 1 hour, 1, 7, 30, 60, 180, and 365 days postprocedure.
  
  
  METHODS
  Intraocular pressure (IOP) and side effects.
  
  
  RESULTS
  Thirty adults were randomized into 2 groups. The mean (±SD) pretreatment IOP was 20.21±3.19 mm Hg for the study group (n=14) and 21.14±2.98 mm Hg for the controls (n=14; P =0.43), dropping to 15.50±3.77 and 15.00±4.08 mm Hg (P =0.74) after 6 months and to 16.00±3.31 and 14.00±2.45 mm Hg (P =0.22) after 12 months. The average IOP reduction after 6 and 12 months was 23.4% and 20.83% for the study group and 27.1% and 33.77% for the controls (P=0.528). Success (a decrease of ≥15% at 6 months with no additional medications, laser, or glaucoma surgery) was achieved in 12 (85.7%) study patients and 9 (69.2%) controls (P=0.385). Complications were mild and transient (n=30), although significantly higher in the controls (n=15; P <0.0001).
  
  
  CONCLUSIONS
  SLT applied directly to the perilimbal sclera may be as efficacious as the conventional procedure for 1 year.
authors.affiliation: *Department of Ophthalmology, Meir Medical Center, Kfar Saba §Department of Ophthalmology, Assaf Harofeh Medical Center †Sackler Faculty of Medicine, Tel Aviv University ‡The Ein Tal Medical Center, Tel-Aviv ∥Department of Ophthalmology, Goldschleger Eye Research Institute, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Noa
authors.initials: N
authors.lastname: Geffen
authors.forename: Shay
authors.initials: S
authors.lastname: Ofir
authors.forename: Avner
authors.initials: A
authors.lastname: Belkin
authors.forename: Fani
authors.initials: F
authors.lastname: Segev
authors.forename: Yaniv
authors.initials: Y
authors.lastname: Barkana
authors.forename: Audrey
authors.initials: A
authors.lastname: Kaplan Messas
authors.forename: Ehud I
authors.initials: EI
authors.lastname: Assia
authors.forename: Michael
authors.initials: M
authors.lastname: Belkin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017889:Exfoliation Syndrome / Q000601:surgery*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006068:Gonioscopy / Q000379:methods*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007557:Israel; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015814:Ocular Hypotension / Q000601:surgery; D011446:Prospective Studies; D012590:Sclera / Q000601:surgery*; D014065:Tonometry, Ocular; D014129:Trabecular Meshwork / Q000601:surgery; D014130:Trabeculectomy / Q000379:methods*; D014792:Visual Acuity