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Current review of Excimer laser Trabeculostomy
Georges M Durr1,2, Marc Töteberg-Harms3, Richard Lewis4
11Department of Ophthalmology, Université de Montréal, Montreal, Quebec Canada.
Eye and Vision (London, England)
|May 12, 2020
Summary
Excimer laser trabeculostomy (ELT) effectively lowers intraocular pressure (IOP) by 20-40% with a good safety profile. This microinvasive glaucoma surgery (MIGS) bypasses outflow resistance without leaving devices in the eye.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Medical Devices
Background:
- Excimer laser trabeculostomy (ELT) is a microinvasive glaucoma surgery (MIGS).
- It utilizes a cold laser to create channels in the trabecular meshwork, reducing fibrosis and bypassing outflow resistance.
- This review evaluates ELT's efficacy and safety.
Purpose of the Study:
- To review the current evidence on the efficacy of Excimer laser trabeculostomy (ELT).
- To assess the safety profile of ELT in glaucoma patients.
Main Methods:
- Systematic review of studies following PRISMA guidelines.
- Searched PubMed, MEDLINE, EMBASE, and Cochrane Controlled Trial Database.
- Included 8 studies (1 RCT, 4 prospective, 5 retrospective) and 2 non-referenced publications.
Main Results:
- ELT demonstrated moderate intraocular pressure (IOP) reduction of 20-40% from baseline.
- Most studies showed a decrease in glaucoma medications.
- The procedure had a favorable safety profile with few complications.
Conclusions:
- ELT shows significant IOP-lowering effects and a favorable safety profile.
- It is effective as a standalone procedure or combined with cataract surgery.
- ELT is an attractive MIGS option without implanted devices, though studies lack controls and washout IOP.
