[Laser surgery for glaucoma: excimer-laser trabeculotomy].

BACKGROUND

Excimer-laser trabeculotomy (ELT) is a new, minimally invasive surgical procedure for the treatment of open-angle glaucoma that can easily be combined with cataract surgery. We herein report our experience with ELT as a stand-alone procedure and ELT plus cataract surgery.

METHODS

A total of 135 patients with open-angle glaucoma (n = 128) or ocular hypertension (n = 7) (M : F = 49 : 86, mean age 69.7 +/- 1.2 years) were included in this study. Patients were divided into 2 groups: a) ELT as a stand-alone procedure (n = 75), b) combined cataract and ELT procedure (n = 60). Both groups were further divided into 2 subgroups: 1) Preoperative IOP > 22 mmHg, 2) Preoperative IOP < or = 22 mmHg. Kaplan-Meier survival curves were calculated. Success criterion was 20 % decrease of IOP and IOP < or = 21 mmHg and postoperative IOP-lowering medication < or = preoperative IOP-lowering medication. Follow-up time was 1 year.

RESULTS

Group a) ELT, 1) preoperative IOP > 22 mmHg, 2) preoperative IOP < or = 22 mmHg: Kaplan-Meier survival curves showed a success rate of 57 % in subgroup 1 and of 41 % in subgroup 2. Group b) Combined cataract and ELT procedure, 1) preoperative IOP > 22 mmHg, 2) Preoperative IOP < or = 22 mmHg: success rate was 91 % in subgroup 1 and 52 % in subgroup 2.

CONCLUSION

ELT is a promising IOP-lowering technique both as a stand-alone procedure and in combination with cataract surgery. It is especially suitable for patients with high preoperative IOP levels.