SCIENCE@home

Real-world results of the Zeiss selective laser trabeculoplasty in adult South African primary open-angle glaucoma patients

Brian Church,Pierre Wassermann

Published 2024 in Therapeutic Advances in Ophthalmology

ABSTRACT

Background: Selective laser trabeculoplasty (SLT) is an effective long-term option for the treatment of open-angle glaucoma. Objectives: To investigate the real-world efficacy and safety of SLT with the Zeiss VISULAS green laser in medically treated primary open-angle glaucoma (POAG). Design: Retrospective, single-center study. Methods: POAG patients ⩾18 years of age on at least one antiglaucoma medication prior to the procedure, who underwent SLT with the Zeiss VISULAS green laser (Carl Zeiss Meditec, Jena, Germany). Medications were terminated or reinstated at subsequent follow-ups depending on the intraocular pressure (IOP) control. The primary efficacy outcome measures were mean reduction in glaucoma medications and mean reduction in IOP at 3, 6, and 12 months compared to baseline. Safety outcomes were intra- or post-procedural complications. Results: One hundred fifty-six eyes of 156 patients, aged 66.5 ± 13.2 years, were recruited. The mean number of medications was reduced from 2.3 ± 1.0 at baseline to 0.8 ± 1.1 and 0.8 ± 1.2 at 3- and 6 months, respectively (p < 0.001). Despite the reduction of medications, the mean IOP (mmHg) was reduced from 16.6 ± 3.10 at baseline to 15.4 ± 3.82 at 3 months (n = 156) and 15.1 ± 3.30 at 6 months (n = 140) (p < 0.001). IOP reduction ⩾20% was observed in 28.8% of patients at 3 months and 27.9% of patients at 6 months. In the 12-month follow-up group (n = 22), mean medications and IOP (mmHg) at baseline were 2.3 ± 0.9 and 16.0 ± 2.80, respectively, which decreased to 0.9 ± 1.1 (p < 0.001) and 14.5 ± 1.92 (p = 0.103), respectively. At 3- and 6-month post-procedure, 59.6% of patients and 60% of patients, respectively, were medication-free compared to none at baseline. At 6 months, 69.3% of patients maintained IOP lower than or equal to pre-procedure IOP on fewer medications compared to baseline. No vision-threatening intra- or post-procedure complications were noted. Conclusion: SLT with the Zeiss VISULAS green laser resulted in a clinically and statistically significant reduction in number of medications needed for IOP control. The procedure had a good safety profile similar to that described in the literature for SLT, with no vision-threatening complications. Plain language summary Exploring the effectiveness of Zeiss VISULAS green laser in reducing medication for open-angle glaucoma patients Open-angle glaucoma is an eye disorder characterized by increased internal eye pressure, which can lead to optic nerve damage and consequent vision loss. Typically managed with medications that lower this pressure, alternative treatments like laser therapies are also available, also know as Selective Laser Trabeculoplasty (SLT). This study examined a new laser’s effectiveness as such an alternative. Researchers conducted a retrospective analysis of adult patients who had received the SLT green laser treatment. These patients had all been using at least one glaucoma medication before undergoing the procedure. The main goal was to assess changes in the number of medications required and eye pressure levels at several time points—three, six, and twelve months after the treatment. The findings were promising. Initially, patients used an average of 2.3 different medications. After the treatment, this average decreased significantly within just three to six months. By six months, about 60% of patients no longer needed any glaucoma medications. Importantly, this reduction in medication did not compromise the control of eye pressure. In fact, the majority of patients maintained lower or stable eye pressure compared to their levels before the treatment. Furthermore, the long-term outcomes (evaluated at twelve months for a smaller group) showed continued effectiveness of the laser treatment with sustained medication reduction and stable eye pressure. Regarding safety, the study underscored a low risk of complications. There were no severe or vision-threatening side effects reported following the laser procedure. Overall, this study supports that this green laser as a beneficial option for managing eye pressure in patients with open-angle glaucoma, offering a potential reduction in the dependence on medications. The treatment is not only effective in lowering eye pressure but also in maintaining these levels with minimal safety concerns.

PUBLICATION RECORD

CITATION MAP

EXTRACTION MAP

CLAIMS

  • No claims are published for this paper.

CONCEPTS

  • No concepts are published for this paper.

REFERENCES

Showing 1-26 of 26 references · Page 1 of 1

CITED BY