Cargando…
Automated Direct Selective Laser Trabeculoplasty: First Prospective Clinical Trial
PURPOSE: Direct selective laser trabeculoplasty (DSLT) is a rapid, noncontact automated procedure performed directly through the limbus without gonioscopy. In this first nonrandomized clinical trial we assessed its safety and ability to reduce intraocular pressure (IOP). METHODS: Fifteen patients (1...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Association for Research in Vision and Ophthalmology
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7938021/ https://www.ncbi.nlm.nih.gov/pubmed/34003939 http://dx.doi.org/10.1167/tvst.10.3.5 |
_version_ | 1783661515686019072 |
---|---|
author | Goldenfeld, Mordechai Belkin, Michael Dobkin-Bekman, Masha Sacks, Zachary Blum Meirovitch, Sharon Geffen, Noa Leshno, Ari Skaat, Alon |
author_facet | Goldenfeld, Mordechai Belkin, Michael Dobkin-Bekman, Masha Sacks, Zachary Blum Meirovitch, Sharon Geffen, Noa Leshno, Ari Skaat, Alon |
author_sort | Goldenfeld, Mordechai |
collection | PubMed |
description | PURPOSE: Direct selective laser trabeculoplasty (DSLT) is a rapid, noncontact automated procedure performed directly through the limbus without gonioscopy. In this first nonrandomized clinical trial we assessed its safety and ability to reduce intraocular pressure (IOP). METHODS: Fifteen patients (15 eyes: 10 with open-angle glaucoma [OAG], 4 with ocular hypertension, and 1 with pseudoexfoliation glaucoma), naive or after medication washout, with an IOP ≥22 mm Hg, underwent DSLT by irradiation with 100 or 120 sequential noncontact 532-nm, Q-switched laser shots (0.8−1.4 mJ) automatically applied during 1.5 or 2.3 seconds on the limbus, guided by image analysis and eye tracking. Results were assessed at 1 and 3 hours, 1 day, 1 week, and 1, 3, and 6 months. RESULTS: The mean ± standard deviation baseline IOP (mm Hg) in all eyes was 26.7 ± 2.3. At 1, 3, and 6 months, this value was significantly reduced to 21.7 ± 4.2 (by 18.1%), to 20.8 ± 2.5 (by 21.4%), and to 21.5 ± 4.1 (by 18.8%), respectively. In six patients treated with 1.4 mJ/shot, the mean IOP at 6 months decreased from 26.7 ± 3.2 to 19.3 ± 2.0 (27.1%, P = 0.03). There was a significant reduction in hypotensive medications (from 1.6 ± 1.0 to 0.4 ± 0.7, P = 0.03). No serious adverse events occurred. CONCLUSIONS: Automated DSLT appears to be an effective and safe noncontact, rapid modality for reducing IOP in patients with OAG. Higher energy usage led to better results. TRANSLATIONAL RELEVANCE: Studying laser transmission through sclera enabled laser irradiation of the trabeculum without gonioscopy. |
format | Online Article Text |
id | pubmed-7938021 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Association for Research in Vision and Ophthalmology |
record_format | MEDLINE/PubMed |
spelling | pubmed-79380212021-03-11 Automated Direct Selective Laser Trabeculoplasty: First Prospective Clinical Trial Goldenfeld, Mordechai Belkin, Michael Dobkin-Bekman, Masha Sacks, Zachary Blum Meirovitch, Sharon Geffen, Noa Leshno, Ari Skaat, Alon Transl Vis Sci Technol Article PURPOSE: Direct selective laser trabeculoplasty (DSLT) is a rapid, noncontact automated procedure performed directly through the limbus without gonioscopy. In this first nonrandomized clinical trial we assessed its safety and ability to reduce intraocular pressure (IOP). METHODS: Fifteen patients (15 eyes: 10 with open-angle glaucoma [OAG], 4 with ocular hypertension, and 1 with pseudoexfoliation glaucoma), naive or after medication washout, with an IOP ≥22 mm Hg, underwent DSLT by irradiation with 100 or 120 sequential noncontact 532-nm, Q-switched laser shots (0.8−1.4 mJ) automatically applied during 1.5 or 2.3 seconds on the limbus, guided by image analysis and eye tracking. Results were assessed at 1 and 3 hours, 1 day, 1 week, and 1, 3, and 6 months. RESULTS: The mean ± standard deviation baseline IOP (mm Hg) in all eyes was 26.7 ± 2.3. At 1, 3, and 6 months, this value was significantly reduced to 21.7 ± 4.2 (by 18.1%), to 20.8 ± 2.5 (by 21.4%), and to 21.5 ± 4.1 (by 18.8%), respectively. In six patients treated with 1.4 mJ/shot, the mean IOP at 6 months decreased from 26.7 ± 3.2 to 19.3 ± 2.0 (27.1%, P = 0.03). There was a significant reduction in hypotensive medications (from 1.6 ± 1.0 to 0.4 ± 0.7, P = 0.03). No serious adverse events occurred. CONCLUSIONS: Automated DSLT appears to be an effective and safe noncontact, rapid modality for reducing IOP in patients with OAG. Higher energy usage led to better results. TRANSLATIONAL RELEVANCE: Studying laser transmission through sclera enabled laser irradiation of the trabeculum without gonioscopy. The Association for Research in Vision and Ophthalmology 2021-03-05 /pmc/articles/PMC7938021/ /pubmed/34003939 http://dx.doi.org/10.1167/tvst.10.3.5 Text en Copyright 2021 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. |
spellingShingle | Article Goldenfeld, Mordechai Belkin, Michael Dobkin-Bekman, Masha Sacks, Zachary Blum Meirovitch, Sharon Geffen, Noa Leshno, Ari Skaat, Alon Automated Direct Selective Laser Trabeculoplasty: First Prospective Clinical Trial |
title | Automated Direct Selective Laser Trabeculoplasty: First Prospective Clinical Trial |
title_full | Automated Direct Selective Laser Trabeculoplasty: First Prospective Clinical Trial |
title_fullStr | Automated Direct Selective Laser Trabeculoplasty: First Prospective Clinical Trial |
title_full_unstemmed | Automated Direct Selective Laser Trabeculoplasty: First Prospective Clinical Trial |
title_short | Automated Direct Selective Laser Trabeculoplasty: First Prospective Clinical Trial |
title_sort | automated direct selective laser trabeculoplasty: first prospective clinical trial |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7938021/ https://www.ncbi.nlm.nih.gov/pubmed/34003939 http://dx.doi.org/10.1167/tvst.10.3.5 |
work_keys_str_mv | AT goldenfeldmordechai automateddirectselectivelasertrabeculoplastyfirstprospectiveclinicaltrial AT belkinmichael automateddirectselectivelasertrabeculoplastyfirstprospectiveclinicaltrial AT dobkinbekmanmasha automateddirectselectivelasertrabeculoplastyfirstprospectiveclinicaltrial AT sackszachary automateddirectselectivelasertrabeculoplastyfirstprospectiveclinicaltrial AT blummeirovitchsharon automateddirectselectivelasertrabeculoplastyfirstprospectiveclinicaltrial AT geffennoa automateddirectselectivelasertrabeculoplastyfirstprospectiveclinicaltrial AT leshnoari automateddirectselectivelasertrabeculoplastyfirstprospectiveclinicaltrial AT skaatalon automateddirectselectivelasertrabeculoplastyfirstprospectiveclinicaltrial |