Early results of selective laser trabeculoplasty in patients resistant to deep sclerectomy

In this study, we aimed to determine the early results of selective laser trabeculoplasty to trabeculo-Descemet membrane in patients resistant to deep sclerectomy (DS) surgery.

Twelve eyes of 12 patients that had undergone DS for primary open-angle glaucoma were enrolled. Preoperative and postoperative intraocular pressures (IOP) were measured by Goldmann applanation tonometer. Time to failure after DS was noted. Failure is described as IOP higher than 20 mm Hg. All patients underwent selective laser trabeculoplasty (SLT) after failure. Eight to 10 applications of SLT were applied over the trabeculo-Descemet membrane. Laser was applied to the surgical site only. The IOPs before SLT, at postoperative first week, first month, and third month were measured.

Mean follow-up time was 23.5 ± 9.5 months. Mean preoperative IOP was 34.2 ± 6.7 mm Hg; mean postoperative IOP at first week was 12.7 ± 3.2 mm Hg. Mean time to failure after DS procedure was 21.6 ± 7.6 months. Mean IOP was 20.6 ± 1.9 mm Hg just before SLT procedure. Mean IOP measurements after SLT at first week, first month, and third month were 10.5 ± 2.2 mm Hg, 10.5 ± 1.9 mm Hg, and 10.9 ± 2.1 mm Hg, respectively.

Selective laser trabeculoplasty after DS is an effective and noninvasive procedure that can be done on an outpatient basis. Our results suggest that SLT applied to the surgical site is an effective intervention in the short term but long-term results are required to assess the efficacy.