Long-term follow-up of intraocular pressure and pressure-lowering medication in patients following Excimer laser trabeculotomy
| Autor: | Alexandra Anton, C. Deubel, Thomas Reinhard, Daniel Böhringer, Jan Lübke |
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| Rok vydání: | 2020 |
| Předmět: |
ELT
Intraocular pressure medicine.medical_specialty genetic structures Open angle glaucoma medicine.medical_treatment Ocular hypertension Glaucoma Trabeculectomy 03 medical and health sciences Cellular and Molecular Neuroscience 0302 clinical medicine medicine Humans Excimer laser trabeculotomy Intraocular Pressure Retrospective Studies Proportional hazards model business.industry MIGS Cataract surgery medicine.disease Trabeculotomy eye diseases Sensory Systems Surgery Ophthalmology Treatment Outcome Cohort 030221 ophthalmology & optometry Lasers Excimer sense organs business Glaucoma Open-Angle 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Graefe's Archive for Clinical and Experimental Ophthalmology |
| ISSN: | 1435-702X 0721-832X |
| Popis: | Background Excimer laser trabeculotomy (ELT) is a minimally invasive procedure to lower the intraocular pressure (IOP) via a photo-ablative laser that is applied to the trabecular meshwork. With this procedure, it is possible to improve the outflow of the aqueous humor. Until now, a limited number of studies examining mostly relatively small sample sizes with midterm follow-up exist. We therefore present the analysis of a large ELT cohort in a long-term follow-up. Methods We recorded data from 580 patients who underwent ELT or combined ELT with cataract surgery at our institution from November 2000 until March 2011. A total of 512 patients with primary open angle glaucoma (POAG), pseudoexfoliation glaucoma (PEX), and ocular hypertension (OHT) were included in the analysis. At every follow-up examination, the usage of IOP-lowering medication and the IOP were recorded. Failure criteria were defined as the need for another surgical glaucoma procedure, when the IOP was not 21 mmHg or less and a reduction of 20% from the baseline was not achieved with (qualified success) or without (absolute success) additional medication. Statistical analysis was done using Kaplan-Meier analysis and Cox regression. Results Four hundred twenty-eight patients underwent combined cataract and ELT surgery, and 84 underwent solitary ELT surgery. After a median follow-up time of 656 days, 87% (combined surgery) and 66% (ELT) of the patients did not have to undergo another IOP-lowering intervention; 47/31% were classified as a qualified success and 31/11% as a complete success. The IOP-lowering medication, however, could not be significantly reduced within that time period. Conclusion Especially when combined with cataract surgery, ELT is a feasible minimally invasive procedure to lower the IOP on a mid- to long-term basis. Over the long term, however, IOP-lowering medication could not be reduced. |
| Databáze: | OpenAIRE |
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