Purpose: This is comparative study for evaluation of the efficacy and lastingness of intraocular pressure (IOP) reduction of selective laser trabeculoplasty (SLT) in exfoliation (EG) and primary open-angle (POAG) glaucoma.
Methods: 48 patients with EG and 48 with POAG were recruited to the study. The angle grade 3 and 4, by Shaffer, were considered to be open. Trabecular meshwork (TM) pigmentation was graded from 0 = no pigmentation, to 4 = dense pigmentation. TM was treated with a 532-nm frequency-doubled, Q-swiched Nd:YAG laser, energy ranged from 0.7 to 2.0 mJ. IOP were measured during one year follow-up.
Results: Patients in the EG group were older than in POAG group and had significantly more pigmented TM. The mean baseline IOP in the EG group was 24.1 (± 4.5) and 23.7 (± 3.3) in the POAG group and in the end of the one-year follow-up 18.6 (± 3.7) and 18.4 (± 2.5) mmHg respectively with no significant difference between two groups. The 12-month success rate was 87.3% and 69.7% in the EG and POAG patients, p= 0.05. Interaction between exfoliation syndrome (EXS) and the energy of the laser, not the level of TM pigmentation was significant predictor of the IOP rise during the follow-up. The odds of a relapse are 2.98 times lower for patients with EXS.
Conclusions: SLT is effective and reduction of IOP is long-lasting in EG and POAG patients. Exfoliative material independently from TM pigmentation seems to have influence to results of SLT.