The AIDA and the extra laser systems for excimer laser trabeculotomy proved comparable IOP lowering efficacy—12-month results

PURPOSE: Cataract surgery combined with excimer laser trabeculotomy (phaco-ELT) leads to a significant reduction in intraocular pressure by enhancing trabecular outflow. The aim of this study is to compare two laser systems for ELT (AIDA vs. ExTra). METHODS: In this retrospective chart review, inclusion criteria were a diagnosis of glaucoma and phaco-ELT between 07/17/2010 and 07/17/2018. Data were collected preoperatively and postoperatively up to 1 year. Success was defined as IOP reduction of ≥ 20% compared to baseline plus an IOP of < 21 mmHg with no hypotony, no loss of light perception vision, and no subsequent glaucoma surgery. RESULTS: Three hundred and fourteen eyes (mean age 75.9 ± 8.6 years) were included. Baseline intraocular pressure (IOP) for the ExTra group (94 eyes) was 20.3 ± 5.9 mmHg on 2.0 ± 1.3 anti-glaucoma drugs (AGD) and a best-corrected visual acuity (BCVA, logMar) of 0.5 ± 0.4. For The AIDA group (220 eyes), baseline IOP was 18.7 ± 6.3 mmHg on 2.0 ± 1.3 AGD and a BCVA of 0.3 ± 0.3. In the ExTra group, IOP was reduced to 12.8 ± 2.5 mmHg (−37%) and in the AIDA group to 14.7 ± 3.9 (−21%, p = 0.14) at 1 year. AGD reduction in the ExTra group was 1.3 ± 1.5 and 1.8 ± 1.4 in the AIDA group (p = 0.14). Success rates were 80% (ExTra) and 70% (AIDA), respectively (p = 0.552). Thirty-one eyes (10.0%) required a subsequent glaucoma surgery during the follow-up. CONCLUSION: Both laser platforms, the ExTra and the AIDA laser, used for Phaco-ELT lead to a significant reduction in intraocular pressure and anti-glaucoma drugs with no statistically significant difference in success rates during the follow-up of 12 months. TRIAL REGISTRATION SWISSETHICS: 2018–01,791.