Evaluation of the efficacy of selective laser trabeculoplasty in the treatment of open angle glaucoma

In our study the efficacy and safety of Selective laser trabeculoplasty (SLT) in the treatment of glaucoma is evaluated.Between February 2009 and April 2010, 49 eyes of 29 patients with a diagnosis of open angle glaucoma at the Afyon Kocatepe University School of medicine, department of ophtalmology glaucoma unit were ıncluded.While the treatment of SLT to 270º trabecular meshwork, with an average of 0.84±0.09 mJ energy totally average of 104.6±21.2 laser spot applied. Total energy used during the treatment was 87.90±17.80 mJ averagely.In SLT patients, IOP was measured pre-treatment, post-treatment 1st hour, 1st week, 1st. month, 3rd month and 6th month. The average IOP before the treatment was compared with the other average IOP of controls. The average IOP was 20.12±3.85 mmHg pre-treatment and average IOP at the post-treatment 1st hour, 1st week, 1st month, 3rd month and 6th month was found respectively 21.88±5.02 mmHg, 17.02±3.81 mmHg, 16.59±3.21 mmHg, 16.80±3.11 mmHg, 16.53±2.23 mmHg. The difference between the IOP pre-treatment and IOP post-treatment 1st hour was not statistically significant (p=0.264). The difference between the IOP pre-treatment and IOP post-treatment 1st week, 1st month, 3rd month and 6th month was statistically significant (p<0.05, ANOVA).In the open angle glaucoma patients who underwent SLT treatment, when IOP change pre-treatment compared with other controls, IOP was decreased 3.10 mmHg (15.40 %) at 1st week, 3.53 mmHg (17.54 %) at 1st month, 3.32 mmHg (16.50 %) at 3rd month and 3.59 mmHg (17.84 %) at 6. month. If IOP that measured at post-treatment 6th month to pre-treatment IOP, IOP was decreased 3 mmHg or more, the treatment was considered successful. Accordingly, rate of patients who were treated with success was 57.1 %.There is not statistically significant difference between younger than 60 years old and older than 60 years old patient groups and phakic and pseudophakic patient groups in terms of IOP reduction and success rate after SLT treatment.When the patient group that used prostaglandin analogue drugs before SLT treatment and after SLT treatment (PG group) compared with the patient group that used non-prostaglandin analogue drugs (non-PG group), mean IOP that measured at the 1st week after SLT treatment was higher in non-PG group than PG group that the difference was statistically significant (p<0.01). There was not statistically significant difference observed between the IOP that measured at the other follow ups.Complications in undergoing SLT patients was; mild pain/discomfort during the treatment (10.2%), an IOP increase less than 5 mmHg 1 hour later SLT, anterior chamber reaction which takes less than 1 week after SLT, in 4 eyes (6.12 %) visual acuity decrease depending on the progression of current cataract and in 3 eyes (6.12 %) follicular conjonctivitis in 2 and 3 weeks after the treatment. Hyphema during the treatment and peripheral anterior synechiae, corneal edema or haze after the treatment was not occured in none of the patients during the follow up.In conclusion; the SLT treatment is an effective and safe treatment method and this method can be used in the treatment of open angle glaucoma patients. More advanced and comprehensive studies are needed for determining the location of SLT treatment in the treatment protocol.