Long-term follow-up of intraocular pressure and pressure-lowering medication in patients following Excimer laser trabecu
- PDF / 668,495 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 107 Downloads / 182 Views
GLAUCOMA
Long-term follow-up of intraocular pressure and pressure-lowering medication in patients following Excimer laser trabeculotomy C. Deubel 1,2 & D. Böhringer 1,2 & A. Anton 1,2 & T. Reinhard 1,2 & J. Lübke 1,2 Received: 10 August 2020 / Revised: 9 November 2020 / Accepted: 23 November 2020 # The Author(s) 2020
Abstract Background Excimer laser trabeculotomy (ELT) is a minimally invasive procedure to lower the intraocular pressure (IOP) via a photo-ablative laser that is applied to the trabecular meshwork. With this procedure, it is possible to improve the outflow of the aqueous humor. Until now, a limited number of studies examining mostly relatively small sample sizes with midterm follow-up exist. We therefore present the analysis of a large ELT cohort in a long-term follow-up. Methods We recorded data from 580 patients who underwent ELT or combined ELT with cataract surgery at our institution from November 2000 until March 2011. A total of 512 patients with primary open angle glaucoma (POAG), pseudoexfoliation glaucoma (PEX), and ocular hypertension (OHT) were included in the analysis. At every follow-up examination, the usage of IOP-lowering medication and the IOP were recorded. Failure criteria were defined as the need for another surgical glaucoma procedure, when the IOP was not 21 mmHg or less and a reduction of 20% from the baseline was not achieved with (qualified success) or without (absolute success) additional medication. Statistical analysis was done using Kaplan-Meier analysis and Cox regression. Results Four hundred twenty-eight patients underwent combined cataract and ELT surgery, and 84 underwent solitary ELT surgery. After a median follow-up time of 656 days, 87% (combined surgery) and 66% (ELT) of the patients did not have to undergo another IOP-lowering intervention; 47/31% were classified as a qualified success and 31/11% as a complete success. The IOP-lowering medication, however, could not be significantly reduced within that time period. Conclusion Especially when combined with cataract surgery, ELT is a feasible minimally invasive procedure to lower the IOP on a mid- to long-term basis. Over the long term, however, IOP-lowering medication could not be reduced.
Key messages Excimer-laser-trabeculotomy was one of the first MIGS procedures feasible for combination with cataract surgery. Its success rate has not been shown in studies with larger cohorts nor longer follow-up. According to our data a satisfying but limited IOP-lowering effect following ELT- or especially ELT-cataract-surgery can be achieved. Reduction of IOP-lowering medications could only be achieved for the first year following ELT- or ELT-cataractsurgery.
Keywords ELT . Excimer laser trabeculotomy . Glaucoma . MIGS
* J. Lübke [email protected] 1
Eye Center, Medical Center – University of Freiburg, Killianstrasse 5, 79106 Freiburg, Germany
2
Faculty of Medicine, University of Freiburg, Freiburg, Germany
Introduction Glaucoma is one of the leading causes of blindness worldwide. Approximately 3.5% of
Data Loading...
