Excimer laser trabeculostomy (ELT), a laser-based MIGS procedure with no implants, enables consistent intraocular pressure-lowering efficacy in glaucoma patients over 8 years both as a stand alone procedure and also combined with phacoemulsification

Session Details

Session Title: Glaucoma II

Session Date/Time: Monday 12/09/2016 | 08:00-10:30

Paper Time: 09:32

Venue: Hall C4

First Author: : M.Berlin USA

Co Author(s): :    M. Toeteberg-Harms   V. Roka   C. Quach   L. Kleineberg   U. Roka        

Abstract Details

Purpose:

To evaluate the long term intraocular pressure lowering efficacy and safety of Excimer Laser Trabeculostomy (ELT) both as a stand alone procedure and ELT combined with phacoemulsification (ELT+Phaco) in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT).

Setting:

Augen Laser Klinik, Detmold, Germany, single surgeon UG.

Methods:

48 eyes of 40 patients with open angle glaucoma or ocular hypertension underwent ab-interno Excimer Laser Trabeculostomy. 43 eyes of 33 patients with open angle glaucoma or ocular hypertension and surgical cataract underwent ELT combined with phacoemulsification. The primary outcome measures are mean change in IOP and in number of glaucoma medications from baseline. Secondary outcome measures are changes in visual acuity (BCVA), surgical complications, and adverse events (AE).

Results:

At 8 years, the mean IOP in the ELT group was reduced by 29.7% from a pre-op IOP of 22.9±5.4mmHg to 16.1±3.4mmHg (p-value IOP <0.001). In the ELT+Phaco group, the mean IOP was reduced by 43.4% from a pre-op IOP of 25.1±6.1mmHg to 14.2±3.1mmHg (p-value IOP <0.001). The number of glaucoma medications at 8 years for the ELT group was 1.2±1.2 medications compared to 1.6±0.7 medications at pre-op (p-value meds 0.152). The number of medications for the ELT+Phaco group was 1.8±0.8 medications compared to 1.3±0.7 medications at pre-op (p-value meds 0.087).

Conclusions:

ELT both as a stand alone MIGS procedure and ELT+Phaco are clinically safe and effective and enable long-term, consistent, significant reductions in IOP in patients with OAG or OHT. Glaucoma medication requirements remained stable. 8 year post ELT IOP reduction with no implants was equivalent to 1 & 5 year data on IOP lowering following combined iStent implants + phacoemulsification. ELT and ELT+Phaco enable consistent IOP lowering for at least 8 years without implants. This study presents the longest post MIGS procedure data which validates the concept of MIGS procedures for IOP lowering.

Financial Disclosure:

NONE