Selective laser trabeculoplasty for the treatment of intraocular pressure elevation after viscocanalostomy with Ologen implant in the management of primary open-angle glaucoma: a retrospective cohort study.

Abstract

Background: Selective laser trabeculoplasty (SLT) is a non-invasive treatment option for glaucoma. It uses a Q-switched Nd: YAG laser. The aim of this study was to evaluate the efficacy of SLT as a treatment option for eyes with primary open-angle glaucoma (POAG) that have previously undergone viscocanalostomy with an Ologen implant, displaying uncontrolled intraocular pressure (IOP).

Methods: This retrospective cohort study included 26 eyes of 26 patients with POAG who had had SLT after viscocanalostomy or phacoviscocanalostomy with Ologen implant. These eyes showed a progression of glaucomatous damage, the IOP was above 21 mmHg, or with intolerable glaucoma medications. SLT was done using Tango Reflex multimodality YAG/SLT laser which is a Q-switched Nd: YAG laser producing a single 532 nm wavelength pulse with a 400 mm spot size and 3 ns pulse duration. The follow-up period was one year.

Results: One year post-SLT, complete success was achieved in 19 cases (73.1%), qualified success in 4 cases (15.4%), and failure in 3 cases (11.5%). The mean decrease in IOP was 5.64 ± 4.05 mmHg, the mean reduction of antiglaucoma medications was 1.00 ± 0.85, and the mean percentage of reduction in IOP was 23.5 ± 16.4. There was a statistically significant decrease in IOP and antiglaucoma medications (p = < 0.01).

Conclusion: SLT is a simple and effective procedure that can be used as a treatment option for eyes with POAG after viscocanalostomy with Ologen implant to reach the target IOP and decrease the number of antiglaucoma medications.