Kristina E. Fittipaldi, BA SUCCESS OF SELECTIVE LASER TRABECULOPLASTY IN PATIENTS WITH THREE TYPES OF GLAUCOMA Richard A. Luck, DO Kristina E. Fittipaldi, BA Arusha Gupta, MD Elaine M. Miglino Lawrence F. Jindra, MD

Financial Disclosures 1st, 2nd, 3rd, and 4th authors have no financial disclosure. 5th author has independently conducted and financed clinical research study presented and provides technical advice and consultant services to Lumenis Corporation. 2

Introduction Selective Laser Trabeculoplasty (SLT) uses a Q-Switched frequency-doubled (532 nm) Nd:YAG laser which targets melanocytes in the pigmented trabecular meshwork.1,2 When treated with SLT, a primarily biologic response is induced in the trabecular meshwork which involves the release of cytokines that trigger macrophage recruitment and other changes leading to IOP reduction.2 It treats the meshwork without causing any thermal or coagulative damage to surrounding structures.1,2 1. Latina MA, et al. Selective targeting of trabecular meshwork cells: in vitro studies of pulsed and cw laser interactions. Exp Eye Res. 1995;60:359-372. 2. Latina MA, et al. Q-switched 532-nm Nd:YAG laser trabeculoplasty (selective laser trabeculoplasty): a multicenter, pilot, clinical study. Ophthalmology. 1998;105:2082-2090. 3

Objective & Methods To examine the effectiveness of SLT in decreasing intraocular pressure (IOP) in patients with primary open angle glaucoma (POAG), exfoliative glaucoma (XFG), and pigmentary glaucoma (PIG). A retrospective chart review was performed on 1827 eyes divided into 3 categories based on type of glaucoma, in a consecutive SLT case series over 5 years. Two-tailed paired t-test was used for each category to compare pre- and post-SLT IOP.

Results: POAG 1735 eyes with POAG received SLT as treatment for glaucoma. IOP decreased from a mean of 19.7 mm Hg ± 5.6 to 14.7 mm Hg ± 4.5. This represents a 25% decrease in IOP or 5.0 mm Hg. Data were significant with P < 0.01.

Results: XFG 78 eyes with XFG received SLT as treatment for glaucoma. IOP decreased from a mean of 21.7 mm Hg ± 5.1 to 16.9 mm Hg ± 6.1. This represents a 22% decrease in IOP or 4.8 mm Hg. Data were significant with P < 0.01.

Results: PIG 14 eyes with PIG received SLT as treatment for glaucoma. IOP decreased from a mean of 21.1 mm Hg ± 5.4 to 15.8 mm Hg ± 5.2. This represents a 25% decrease in IOP or 5.3 mm Hg. Data were significant with P < 0.01.

Data Glaucoma Type POAG XFG PIG 1735 78 14 19.7 21.7 21.1 14.7 16.9 Number of eyes (n) 1735 78 14 Pre-SLT IOP (mm Hg) 19.7 21.7 21.1 Post-SLT IOP (mm Hg) 14.7 16.9 15.8 IOP change (mm Hg) 5.0 4.8 5.3 %  IOP 25 22 P-value < 0.01

Results

Summary Mean Post-SLT reduction in IOP: POAG 25% XFG 22% PIG 25% The results were significant with P < 0.01.

Conclusion In this clinical series, SLT significantly lowered intraocular pressure in patients with primary open angle glaucoma, exfoliative glaucoma, and pigmentary glaucoma, when used as a treatment for glaucoma.