The outcome of 270-degree selective laser trabeculoplasty

Abstract

Purpose. To evaluate the reduction of intraocular pressure (IOP) by a single-session 270° selective laser trabeculoplasty (SLT) in pseudoexfoliation glaucoma (PXFG) and primary open angle glaucoma (POAG) patients. Methods. A successful outcome was defined as an IOP reduction ≥20% from baseline with no further need for laser or incisional surgery. The preoperative pharmaceuticals were maintained unchanged throughout the course of the study. 70-80 nonoverlapping pulses were distributed around 270° in the trabecular band. Results. Sixty-six eyes of 42 patients with PXFG (30 eyes) or POAG (36 eyes) met the inclusion criteria. The mean ± standard deviation preoperative IOP was 23.7 ± 4.5 mmHg and at the end of the followup was 19.0 ± 4.5 mmHg with a pressure drop of 4.7 ± 3.1 mmHg (20%) (P < 0.001, 95% confidence interval 3.94-5.46). The cumulative probability of success was 39% (26 of 66 eyes) after 6 months of followup. Statistically significant differences in success rates were observed between the PXFG and POAG groups (27% versus 50%; P = 0.025). Postoperative inflammatory reaction was scanty. Conclusions. 270-degree SLT is useful in lowering IOP in PXFG and POAG, but the average reduction of IOP seems to be within the same range as reported with 180-degree SLT previously.

Figure 1

Kaplan-Meier survival curve for 66 eyes of 42 patients after 270° SLT treatment. Success was defined as an IOP reduction ≥20% from baseline without changing the antiglaucoma medication with no need for further laser trabeculoplasty or glaucoma surgery.

Figure 2

Kaplan-Meier survival curves for eyes with POAG (Curve 1) versus eyes with PXFG (Curve 2) with the success criteria defined as an IOP reduction ≥20% from baseline without changing the antiglaucoma medication with no need for further laser trabeculoplasty or glaucoma surgery; P = 0.025 log rank test.