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Long-term follow-up of intraocular pressure and pressure-lowering medication in patients following Excimer laser trabeculotomy
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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8016798/ https://www.ncbi.nlm.nih.gov/pubmed/33289863 http://dx.doi.org/10.1007/s00417-020-05029-4 |
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author | Deubel, C. Böhringer, D. Anton, A. Reinhard, T. Lübke, J. |
author_facet | Deubel, C. Böhringer, D. Anton, A. Reinhard, T. Lübke, J. |
author_sort | Deubel, C. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-8016798 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-80167982021-04-16 Long-term follow-up of intraocular pressure and pressure-lowering medication in patients following Excimer laser trabeculotomy Deubel, C. Böhringer, D. Anton, A. Reinhard, T. Lübke, J. Graefes Arch Clin Exp Ophthalmol Glaucoma 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. Springer Berlin Heidelberg 2020-12-08 2021 /pmc/articles/PMC8016798/ /pubmed/33289863 http://dx.doi.org/10.1007/s00417-020-05029-4 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Glaucoma Deubel, C. Böhringer, D. Anton, A. Reinhard, T. Lübke, J. Long-term follow-up of intraocular pressure and pressure-lowering medication in patients following Excimer laser trabeculotomy |
title | Long-term follow-up of intraocular pressure and pressure-lowering medication in patients following Excimer laser trabeculotomy |
title_full | Long-term follow-up of intraocular pressure and pressure-lowering medication in patients following Excimer laser trabeculotomy |
title_fullStr | Long-term follow-up of intraocular pressure and pressure-lowering medication in patients following Excimer laser trabeculotomy |
title_full_unstemmed | Long-term follow-up of intraocular pressure and pressure-lowering medication in patients following Excimer laser trabeculotomy |
title_short | Long-term follow-up of intraocular pressure and pressure-lowering medication in patients following Excimer laser trabeculotomy |
title_sort | long-term follow-up of intraocular pressure and pressure-lowering medication in patients following excimer laser trabeculotomy |
topic | Glaucoma |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8016798/ https://www.ncbi.nlm.nih.gov/pubmed/33289863 http://dx.doi.org/10.1007/s00417-020-05029-4 |
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