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Selective Laser Trabeculoplasty for Medically Uncontrolled Pseudoexfoliation Glaucoma in Korean Patients

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Purpose: This study investigated the efficacy and safety of selective laser trabeculoplasty (SLT) in Korean patients with medicallyuncontrolled pseudoexfoliation glaucoma (PEXG). Methods: This retrospective observational study enrolled 43 medically uncontrolled PEXG patients who underwent a 360°SLT and were followed up for at least 12 months after SLT. The intraocular pressure (IOP) before and after SLT at 1 week, 1, 3,6, and 12 months was evaluated. Treatment success was defined as an IOP reduction of ≥20% from the baseline and an IOPequal to lower than 22 mmHg without additional anti-glaucomatous intervention. Additionally, every follow-up medical recordwas reviewed to assess any possible side effects of SLT. Results: Based on the Kaplan-Meier survival analysis, the treatment success rate at 12 months after SLT was 41.9% (18 eyes). For the success group at the 12 months follow-up, SLT showed a mean IOP reduction of 10.3 ± 5.0 mmHg (from 25.6 ± 4.4 to15.2 ± 2.9 mmHg; 39.3%, p < 0.05). Among the 25 eyes that were considered as the treatment failure group, 14 eyes underwentglaucoma filtering surgeries, four eyes received additional SLT, and further intervention and follow-up was refused forseven eyes. During the overall follow-up period, there were no significant adverse events. Conclusions: SLT is a partially effective and safe procedure for lowering IOP in Korean patients with medically refractoryPEXG. Therefore, it can be considered as one of the alternative treatment modalities in patients who are at high risk for conventionalfiltering surgery.

Abstract

Purpose: This study investigated the efficacy and safety of selective laser trabeculoplasty (SLT) in Korean patients with medicallyuncontrolled pseudoexfoliation glaucoma (PEXG). Methods: This retrospective observational study enrolled 43 medically uncontrolled PEXG patients who underwent a 360°SLT and were followed up for at least 12 months after SLT. The intraocular pressure (IOP) before and after SLT at 1 week, 1, 3,6, and 12 months was evaluated. Treatment success was defined as an IOP reduction of ≥20% from the baseline and an IOPequal to lower than 22 mmHg without additional anti-glaucomatous intervention. Additionally, every follow-up medical recordwas reviewed to assess any possible side effects of SLT. Results: Based on the Kaplan-Meier survival analysis, the treatment success rate at 12 months after SLT was 41.9% (18 eyes). For the success group at the 12 months follow-up, SLT showed a mean IOP reduction of 10.3 ± 5.0 mmHg (from 25.6 ± 4.4 to15.2 ± 2.9 mmHg; 39.3%, p < 0.05). Among the 25 eyes that were considered as the treatment failure group, 14 eyes underwentglaucoma filtering surgeries, four eyes received additional SLT, and further intervention and follow-up was refused forseven eyes. During the overall follow-up period, there were no significant adverse events. Conclusions: SLT is a partially effective and safe procedure for lowering IOP in Korean patients with medically refractoryPEXG. Therefore, it can be considered as one of the alternative treatment modalities in patients who are at high risk for conventionalfiltering surgery.

참고문헌 (28)

  1. Leske MC, "Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial", Arch Ophthalmol, 121, pp.48~56 (2003)
  2. Latina MA, "Selective targeting of trabecular meshwork cells: in vitro studies of pulsed and CW laser interactions", Exp Eye Res, 60, pp.359~371 (1995)
  3. Chi SC, "Selective laser trabeculoplasty versus medication for open-angle glaucoma:systematic review and meta-analysis of randomised clinical trials", Br J Ophthalmol, 104, pp.1500~1507 (2020)
  4. Garg A, "Efficacy of repeat selective laser trabeculoplasty in medication-naive open-angle glaucoma and ocular hypertension during the LiGHT trial", Ophthalmology, 127, pp.467~476 (2020)
  5. Kennedy JB, "Selective laser trabeculoplasty: an update", Asia Pac J Ophthalmol (Phila), 5, pp.63~69 (2016)
  6. Miki A, "Treatment outcomes and prognostic factors of selective laser trabeculoplasty for open-angle glaucoma receiving maximal-tolerable medical therapy", J Glaucoma, 25, pp.785~789 (2016)
  7. 박혜원, "약물로 조절되지 않는 개방각녹내장에서 선택적레이저섬유주성형술의 효용성", 대한안과학회지, 58(7), pp.828~835 (2017), 대한안과학회
  8. Konstas AG, "Epidemiology of exfoliation syndrome", J Glaucoma, 27(Suppl 1), pp.S4~S11 (2018)
  9. Ritch R, "Exfoliation syndrome", Surv Ophthalmol, 45, pp.265~315 (2001)
  10. Kanthan GL, "Pseudoexfoliation syndrome and the long-term incidence of cataract and cataract surgery: the blue mountains eye study", Am J Ophthalmol, 155, pp.83~88 (2013)
  11. 최진, "한국인에서 거짓비늘증후군의 임상양상", 대한안과학회지, 47(4), pp.577~586 (2006), 대한안과학회
  12. Gracner T, "Intraocular pressure response of capsular glaucoma and primary open-angle glaucoma to selective Nd:YAG laser trabeculoplasty: a prospective, comparative clinical trial", Eur J Ophthalmol, 12, pp.287~292 (2002)
  13. Vesti E, "Exfoliation syndrome and exfoliation glaucoma", Prog Retin Eye Res, 19, pp.345~368 (2000)
  14. Katsanos A, "A review of the clinical usefulness of selective laser trabeculoplasty in exfoliative glaucoma", Adv Ther, 35, pp.619~630 (2018)
  15. Goldenfeld M, "Selective laser trabeculoplasty in uncontrolled pseudoexfoliation glaucoma", Ophthalmic Surg Lasers Imaging, 42, pp.390~393 (2011)
  16. Goosen E, "Racial differences in selective laser trabeculoplasty efficacy", J Curr Glaucoma Pract, 11, pp.22~27 (2017)
  17. Kaliaperumal S, "Pseudoexfoliation on pseudophakos", Indian J Ophthalmol, 61, pp.359~361 (2013)
  18. Mohan A, "Pseudoexfoliation on pseudophakos", Indian J Ophthalmol, 64, pp.949~ (2016)
  19. Park KA, "Pseudoexfoliative material on the IOL surface and development of glaucoma after cataract surgery in patients with pseudoexfoliation syndrome", J Cataract Refract Surg, 33, pp.1815~1818 (2007)
  20. Melamed S, "Selective laser trabeculoplasty as primary treatment for open-angle glaucoma: a prospective, nonrandomized pilot study", Arch Ophthalmol, 121, pp.957~960 (2003)
  21. Shazly TA, "Long-term safety and efficacy of selective laser trabeculoplasty as primary therapy for the treatment of pseudoexfoliation glaucoma compared with primary open-angle glaucoma", Clin Ophthalmol, 5, pp.5~10 (2010)
  22. Garg A, "Selective laser trabeculoplasty: past, present, and future", Eye (Lond), 32, pp.863~876 (2018)
  23. Ayala M, "Comparison of selective laser trabeculoplasty (SLT) in primary open angle glaucoma and pseudoexfoliation glaucoma", Clin Ophthalmol, 5, pp.1469~1473 (2011)
  24. Lindegger DJ, "Long-term effect of selective laser trabeculoplasty on intraocular pressure in pseudoexfoliation glaucoma", Klin Monbl Augenheilkd, 232, pp.405~408 (2015)
  25. Miraftabi A, "Selective laser trabeculoplasty in patients with pseudoexfoliative glaucoma vs primary open angle glaucoma: a oneyear comparative study", Int J Ophthalmol, 9, pp.406~410 (2016)
  26. Hodge WG, "Baseline IOP predicts selective laser trabeculoplasty success at 12 months post-treatment: results from a randomised clinical trial", Br J Ophthalmol, 89, pp.1157~1160 (2005)
  27. Pillunat KR, "Preoperative intraocular pressure as a predictor of selective laser trabeculoplasty efficacy", Acta Ophthalmol, 94, pp.692~696 (2016)
  28. Hollo G, "Management of exfoliative glaucoma: challenges and solutions", Clin Ophthalmol, 9, pp.907~919 (2015)

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