Medical Journal of Babylon Vol. 12- no. 3: 867-869, 2015
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- ISSN 2312-6760©2015 University of Babylon
- Introduction
- Materials and Methods
  
Medical Journal of Babylon Vol. 12- No. 3: 867-869, 2015 http://www.medicaljb.com ISSN 2312-6760©2015 University of Babylon Short Communication The Efficacy of SLT (Selective Laser Trabeculoplasty) as Primary Treatment For Patients with Primary Open Angle Glaucoma Mustafa Tawfiq Al-Rubaei College of Medicine , University of Babylon , Hilla , IRAQ E-mail : mustafatawfiq555@gmail.com Accepted 16 June,2015 Abstract To see the effectiveness of SLT as primary treatment for patients with primary pen angle glaucoma(poag) The study was conducted at my clinic in Al Hilla city Babylone Iraq 21 patients were treated 4 of them both eyes treated with slt all the patient were not receiving any anti glaucoma medication and follow up for one year . All the patients were having drop in their iop reading as compared to their first visit with a range of about 30% Slt is a very effective technique in lowering and controlling iop when it is used as primary treatment in patients with poag.
Hence was the need to use more safe kind of laser, in 2001 the FDA approve the use of SLT selective laser trabeculoplasty for the treatment of POAG [3]. SLT is a cold laser with selective theromolysis to the pigmented cells with minimal or no destruction to the surrounding tissues & structures which does not compromise the efficacy of SLT in lowering the intra-ocular pressure [4-5]. The study of Mcllarith et al published in the Journal of Glaucoma in 2006 showed that SLT lowers IOP as effective as prostaglandins [6-8]. How does SLT works; By a complex cellular and biomechanical cascade which proposes that laser energy recruits macrophages to the trabecular meshwork by increase the expression of biological cytokines and cellular mediator activities [9-11], macrophages remove obstructive proteins and remodel the TM. Thus
The study was conducted at my clinic in Al-Hilla city, Babylon, Iraq. The aim of this study is to see the efficacy of SLT in lowering intra-ocular pressure in patients with primary open angle Glaucoma if used as a primary therapy before giving the patient any topical or systemic intra-ocular pressure lowering agent. 21 eyes of 17 patients 4 of them both eyes were treated, the diagnosis of Glaucoma was based on measuring the itra-ocular pressure using Goldman tonometry, visual field using automated perimetry and fundus examination to see the optic nerve cupping. 5 patients were lowering pseudoexfoliative Glaucoma. The age of the patients ranging from 55 years old up to 65 years old. SLT done in my clinic using SLT device trabiculus manufactured by the German company ARC. Pilocarpine 4% along with topical anesthesia(tetracaine) were giving before doing the procedure. 100 shoot 360 were giving the patient given steroid as fleuromethelome post operatively and examined after 1 week postoperatively. Then examined after 1 month and then examined monthly for about 1 year. As shown in Table(1) Table 1
Table 2
The values that carry the same letter (b) shows no significant changes between them regarding the values of mean and standard deviation (P<0.05). Results We use RLSD (revised least significant difference) and Duncan's Multiple Ranqe tests the result was as shown in Table (2) there is significant drop in IOP following 1 week and month & 6 month and 1 year, comparing with the first visit. Discussion As it is obvious from the result as it's shown in Table(2), and if we see the Table(1), it is clear that there is significant drop in IOP for those eye treated by SLT as primary treatment, the drop is about 1/3 if we take the mean of all the eyes treated and as we go further through the follow up it's obvious that there is only little flactuntion but the most important is that the IOP remain within acceptable range. Most of the patients that their presenting IOP less than 30 mmlhggot the best results.
SLT as primary treatment for POAG is highly effective and promising non- invasive techniqueespecially if we compare it with ALT or with the high coast and side effect of Anti Glaucoma drops. References
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