Novel treatment for open-angle glaucoma: micropulse laser trabeculoplasty

Session Details

Session Title: Glaucoma I

Session Date/Time: Monday 07/09/2015 | 08:00-10:30

Paper Time: 10:04

Venue: Room 10

First Author: : J.Lee HONG KONG

Co Author(s): :    G. Yau   D. Yick   C. Yuen              

Abstract Details

Purpose:

To investigate the safety and efficacy of using MicroPulse Laser Trabeculoplasty (MLT) in the treatment of open-angle glaucoma (OAG).

Setting:

This prospective cohort included subjects ≥18 years-old with OAG, defined as open angle on gonioscopy with glaucomatous defects on Humphrey visual field or Optical Coherence Tomography. Subjects with IOP<21 mmHg were classified as normal tension glaucoma and those with IOP ≥21 mmHg were classified as primary open angle glaucoma. Caritas Medical Centre in Hong Kong

Methods:

MLT was delivered using a 577 nm diode laser to 360° of the trabecular meshwork unilaterally. Medications were titrated at 1 month after laser to achieve a 25% IOP reduction from presentation or an IOP <18 mmHg. The following were compared using the Repeated Measures ANOVA with Bonferroni's Multiple Comparison Test: IOP (on presentation, pre-MLT and day 1, 1week, 1, 3, and 6 months after MLT) and the number of medications (pre-MLT and 3 and 6 months after MLT). After 6 months, responders with initial success to MLT (IOP reduction ≥20% at 1 month) received treatment in the fellow eye.

Results:

In 48 subjects a mean of 120.5±2.0 MLT shots were applied using a mean energy of 1000mW per shot. Only 7.5% had a mild anterior uveitis post-laser with no change in the Snellen visual acuity at 6 months (P's<0.5). The IOP and number of medications were significantly reduced at all time intervals following MLT compared to pre-MLT (P's<0.0001). At 6 months, the IOP was reduced by 19.5% in addition to a 21.4% reduction in medication compared to pre-treatment levels. MLT success rate was 72.9%. During the first 6 months only 2.1% required a repeated laser.

Conclusions:

MLT was effective in reducing IOP and medications in OAG with minimal post-laser inflammation and low failure rate at 6-months following laser.

Financial Interest:

NONE