Efectos corneales de la trabeculoplastia láser selectiva

Abstract

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.