TY - JOUR
T1 - Selective laser trabeculoplasty following failed combined phacoemulsification cataract extraction and ab interno trabeculectomy
AU - Töteberg-Harms, Marc
AU - Rhee, Douglas J.
N1 - Funding Information:
All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Financial disclosures are as follows: M.T.H.: personal funding by the Swiss National Science Foundation (SNSF Project No. PBZHP3_141457 ); D.J.R.: research funding from Alcon, Aquesys, Merck ; ad hoc consultant, Aerie, Alcon, Allergan, Aquesys, Merck, Santen . Contributions of authors: design of the study (M.T.H., D.J.R.); conduct of the study (M.T.H., D.J.R.); collection, management, analysis, and interpretation of the data (M.T.H., D.J.R.); and preparation, review, and approval of the manuscript (M.T.H., D.J.R.).
PY - 2013/11
Y1 - 2013/11
N2 - Purpose To assess the effect of selective laser trabeculoplasty (SLT) following failed phacoemulsification cataract extraction combined with ab interno trabeculectomy (AIT) using the Trabectome (phaco-trabectome). Design Randomized, interventional case series. Methods Retrospectively, the medical records of patients who underwent SLT between March 2010 and July 2012 by 1 surgeon at a single center after a failed phaco-AIT were evaluated. Inclusion criteria were age ≥18 years with no upper limit and prior failed phaco-AIT attributable to glaucoma progression. Exclusion criterion was performance of any additional glaucoma procedure with influence on intraocular pressure (IOP) during follow-up and a follow-up after surgery of <3 months. Success was defined by reduction of IOP of >3 mm Hg and 20% and number of antiglaucoma medications equal to or less than baseline. Main outcome measures were IOP, antiglaucoma medications, time to failure, and Kaplan-Meier survival curve. Results Fourteen eyes of 13 subjects were included. Mean follow-up after SLT was 12.9 ± 8.7 months. Total laser energy was 59.5 ± 8.7 mJ. Baseline IOP was 17.9 ± 3.3 mm Hg and number of antiglaucoma medications at baseline was 2.0 ± 1.0. All SLT procedures failed. Median time to failure after SLT was 3.6 ± 0.8 (range 2.1-5.1) months. Number of antiglaucoma medications did not change. Conclusions In eyes in which the IOP was no longer controlled following phaco-trabectome, SLT had a limited duration of significant IOP-lowering effect. Other alternatives, such as incisional filtration surgery, should be considered following failed phaco-trabectome.
AB - Purpose To assess the effect of selective laser trabeculoplasty (SLT) following failed phacoemulsification cataract extraction combined with ab interno trabeculectomy (AIT) using the Trabectome (phaco-trabectome). Design Randomized, interventional case series. Methods Retrospectively, the medical records of patients who underwent SLT between March 2010 and July 2012 by 1 surgeon at a single center after a failed phaco-AIT were evaluated. Inclusion criteria were age ≥18 years with no upper limit and prior failed phaco-AIT attributable to glaucoma progression. Exclusion criterion was performance of any additional glaucoma procedure with influence on intraocular pressure (IOP) during follow-up and a follow-up after surgery of <3 months. Success was defined by reduction of IOP of >3 mm Hg and 20% and number of antiglaucoma medications equal to or less than baseline. Main outcome measures were IOP, antiglaucoma medications, time to failure, and Kaplan-Meier survival curve. Results Fourteen eyes of 13 subjects were included. Mean follow-up after SLT was 12.9 ± 8.7 months. Total laser energy was 59.5 ± 8.7 mJ. Baseline IOP was 17.9 ± 3.3 mm Hg and number of antiglaucoma medications at baseline was 2.0 ± 1.0. All SLT procedures failed. Median time to failure after SLT was 3.6 ± 0.8 (range 2.1-5.1) months. Number of antiglaucoma medications did not change. Conclusions In eyes in which the IOP was no longer controlled following phaco-trabectome, SLT had a limited duration of significant IOP-lowering effect. Other alternatives, such as incisional filtration surgery, should be considered following failed phaco-trabectome.
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U2 - 10.1016/j.ajo.2013.05.044
DO - 10.1016/j.ajo.2013.05.044
M3 - Article
C2 - 23932217
AN - SCOPUS:84886101605
SN - 0002-9394
VL - 156
SP - 936-940.e2
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
IS - 5
ER -