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[Laser trabeculoplasty or goniotrepanation. A prospective comparative study].
Klinische Monatsblatter Fur Augenheilkunde
|February 1, 1987
Summary
Goniotrephination effectively lowers intraocular pressure in glaucoma patients, showing superior results compared to laser trabeculoplasty. This surgical procedure is recommended for significant pressure reduction needs.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Intraocular Pressure Management
Background:
- Glaucoma management often requires surgical intervention to reduce intraocular pressure (IOP).
- Laser trabeculoplasty and goniotrephination are established surgical options for glaucoma treatment.
Purpose of the Study:
- To compare the efficacy and outcomes of laser trabeculoplasty versus goniotrephination in glaucoma patients.
- To evaluate the impact of these procedures on intraocular pressure, visual fields, and visual acuity.
Main Methods:
- A consecutive series of glaucoma patients underwent either laser trabeculoplasty (115 eyes) or goniotrephination (44 eyes).
- Follow-up ranged from 3 to 29 months, with assessments of IOP, visual field sensitivity, and visual acuity.
Main Results:
- Goniotrephination achieved a 91% success rate in IOP control, significantly higher than laser trabeculoplasty (50% meeting criteria).
- Mean IOP reduction was greater with goniotrephination (46%) compared to laser trabeculoplasty (19%).
- Visual field sensitivity improved post-goniotrephination, while remaining unchanged after laser trabeculoplasty; however, goniotrephination had a higher incidence of visual acuity reduction and acute cataract formation.
Conclusions:
- Goniotrephination is preferred over laser trabeculoplasty when substantial intraocular pressure reduction is necessary, particularly in cases with extensive visual field loss or very high IOP.
- While goniotrephination offers more significant IOP lowering, potential complications like cataract formation and visual acuity reduction should be considered.