Corneal effects of selective laser trabeculoplasty
DOI:
https://doi.org/10.70313/2718.7446.v16.n02.225Keywords:
glaucoma, open-angle glaucoma, SLT, adverse reactionsAbstract
Purpose: To evaluate the qualitative and quantitative corneal changes after selective laser trabeculoplasty (SLT) and determine its effect on reducing intraocular pressure (IOP).
Introduction: IOP is the main risk factor for glaucoma and the only one that can be modified. Lowering IOP has been shown to delay the progression of the disease, so all currently available treatments aim for a hypotensive effect. SLT is a proper therapeutic alternative for most types of open-angle glaucoma and ocular hypertension (OHT), with few complications that are generally mild and self-resolving.
Methods: This prospective cohort study with short-term follow-up included patients over 18 years old, diagnosed with primary or secondary open-angle glaucoma or OHT, who received SLT to 360° of the trabecular meshwork. Slit-lamp examination and specular microscopy were performed before the procedure and 1 hour, 24 hours, and 1 month after SLT.
Results: 44 eyes with a mean age of 63,86 ± 13,89 years old were evaluated. Most of them presented OHT (41%) and pseudoexfoliative glaucoma (32%). A significant association between SLT and the presence of epithelial keratitis, corneal edema and endothelial dark spots was observed (p <0,05). All corneal changes return to the baseline one month after the procedure. The endothelial cells count and the percentage of hexagonal cells remained stable in all the controls. A significant decrease in IOP was demonstrated after SLT and in the use of topical hypotensive medication (p <0,05).
Conclusion: SLT is an effective treatment with transient and mild corneal effects.
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References
McAlinden C. Selective laser trabeculoplasty (SLT) vs other treatment modalities for glaucoma: systematic review. Eye (Lond) 2014; 28: 249-258.
Kang JM, Tanna AP. Glaucoma. Med Clin North Am 2021; 105: 493-510.
Schuster AK, Wagner FM, Pfeiffer N, Hoffmann EM. Risk factors for open-angle glaucoma and recommendations for glaucoma screening. Ophthalmologe 2021; 118 (Suppl 2): 145-152.
American Academy of Ophthalmology. Glaucoma 2020/2021. San Francisco: American Academy of Ophthalmology, 2021, p. 4-7.
Gazzard G, Konstantakopoulou E, LiGHT Trial Study Group et al. Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (LiGHT): a multicentre randomised controlled trial. Lancet 2019; 393: 1505-1516.
Marshall LL, Hayslett RL, Stevens GA. Therapy for open-angle glaucoma. Consult Pharm 2018; 33: 432-445.
Song J. Complications of selective laser trabeculoplasty: a review. Clin Ophthalmol 2016; 10: 137-143.
Latina MA, de Leon JMS. Selective laser trabeculoplasty. Ophthalmol Clin North Am 2005; 18: 409-419.
Wood SD, Elam A, Moroi S. Rare corneal complication following selective laser trabeculoplasty. Am J Ophthalmol Case Rep 2018; 10: 28-31.
Realini T. Selective laser trabeculoplasty: a review. J Glaucoma 2008; 17: 497-502.
Regina M, Bunya VY, Orlin SE, Ansari H. Corneal edema and haze after selective laser trabeculoplasty. J Glaucoma 2011; 20: 327-329.
Örnek N, Örnek K. Corneal endothelial changes following a single session of selective laser trabeculoplasty for pseudoexfoliative glaucoma. Int Ophthalmol 2018; 38: 2327-2333.
Mangeaud A, Elías Panigo DH. R-Medic: un programa de análisis estadísticos sencillo e intuitivo. Methodo 2018; 3: 18-22. Disponible en: https://methodo.ucc.edu.ar/index.php/methodo/article/view/64
Lee JWY, Chan JCH, Chang RT et al. Corneal changes after a single session of selective laser trabeculoplasty for open-angle glaucoma. Eye (Lond) 2014; 28: 47-52.
Ozkok A, Tamcelik N, Comlekoglu DU, Iskeleli G. Corneal decompensation after selective laser trabeculoplasty. Case Rep Ophthalmol Med 2014; 2014: 851971.
Fechtner RD, Godfrey DG, Budenz D et al. Prevalence of ocular surface complaints in patients with glaucoma using topical intraocular pressure-lowering medications. Cornea 2010; 29: 618-621.
Ong K, Ong L, Ong LB. Corneal endothelial abnormalities after selective laser trabeculoplasty (SLT). J Glaucoma 2015; 24: 286-290.
White AJR, Mukherjee A, Hanspal I et al. Acute transient corneal endothelial changes following selective laser trabeculoplasty. Clin Exp Ophthalmol 2013; 41: 435-441.
Özen B, Öztürk H, Yüce B. Comparison of the effects of 180° and 360° applications of selective laser trabeculoplasty on intraocular pressure and cornea. Int Ophthalmol 2020; 40: 1103-1110.
Kanagaratnam A, Ong K. Quantitative and morphological corneal endothelial changes after selective laser trabeculoplasty and retinal photocoagulation. Asia Pac J Ophthalmol (Phila) 2020; 9: 20-24.
Garg A, Vickerstaff V, Laser in Glaucoma and Ocular Hypertension Trial Study Group et al. Primary selective laser trabeculoplasty for open-angle glaucoma and ocular hypertension: clinical outcomes, predictors of success, and safety from the laser in glaucoma and ocular hypertension trial. Ophthalmology 2019; 126: 1238-1248.
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