Article
Excimer-laser trabeculostomy, a new minimally invasive glaucoma operation
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Published: | September 22, 2004 |
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Outline
Text
Objective
Excimer-laser trabeculostomy (ELT) is a new surgical technique to reduce intraocular pressure (IOP) in patients with glaucoma or ocular hypertension. Our purpose was to examine IOP-reduction in patients treated wit ELT, and to evaluate the number of additional antiglaucoma drugs (AGD) and the safety of this laser treatment .
Methods
To increase the outflow of aqueous humour, on average 10 microperforations of the trabecular meshwork were performed by an endoscope guided photoablative laser probe (Excimer laser, AIDA, TUI-Laser, Munich). In our retrospective pilot study one group of patients received only an ELT, the other group got a combined surgery consisting of ELT + phacoemulsification because of lens opacification. The group with phacoemulsification + ELT was compared to patients with ocular hypertension or glaucoma who were treated with cataract surgery only. IOP, visual acuity and antiglaucoma drugs (AGD) were determined preoperatively (T0) and 2-4 months (T1), 5-7 months (T2), 11-13 months (T3) and 22-26 (T4) months after the surgery.
Results
In the ELT only group the IOP was reduced from 24,1 (n=69) mmHg preoperatively to 18,8 (T1, n=66), 20,0 (T2, n=46), 17,3 (T3, n= 23), 16,5 (T4, n=2) mmHg resp.. The number of AGD was 1,9 (T0), 1,2 (T1), 1,3 (T2), 2,0 (T3), 0,5 (T4). In phacoemulsification + ELT an IOP-reduction from 22,5 mmHg (T0, n=50) to 16,6 (T1, n=47), 16,0 (T2, n=33), 16,5 (T3, n=16),14,0 (T4, n=2) mmHg resp. was observed. The number of AGD was not significantly reduced (1,1 (T0), 0,8 (T1), 1,2 (T2), 1,2 (T3), 1,0 (T4)). IOP decreased from 20,8 (T0) to 18,1 (T2) and 18,3 (T3) mmHg in eyes with phacoemulsification only.
Conclusions
ELT, especially in combination with phacoemulsification, is a new promising laser treatment to reduce IOP for at least 1-2 years.