Abstract
Aim
To retrospectively evaluate the effectiveness and reliability of selective laser trabeculoplasty (SLT) treatment in juvenile open angle glaucoma (JOAG) cases.
Material and method
The 46 eyes of 28 cases that had undergone SLT for JOAG and had a follow-up of at least one month were included in the study. The pre-SLT, month 1, month 6, year 1, year 2, and final follow-up intraocular pressure (IOP); the number of drugs before and after the SLT procedure; and the complications caused by the SLT were recorded. An IOP below 21 mmHg without any additional medication or glaucoma surgery and an IOP decrease of 20% or more compared to the baseline were considered successful.
Results
There were 18 females and 10 males with a mean age of 17.52 ± 2.7 (13–22) years. The cases were followed-up for a mean duration of 39 (5–59) months. The mean IOP was 23.93 ± 0.52 mmHg before SLT and decreased to 17.15 ± 0.57 mmHg at month 1 after the procedure, 17.17 ± 0.52 mmHg at month 6, 18.02 ± 0.77 mmHg at year 1, 18.12 ± 0.48 mmHg at year 2, and 20.93 ± 0.69 mmHg at the final follow-up. The post-SLT IOP measurements at all times were found to be significantly lower than the pre-SLT values (p < 0.001). The mean number of drugs was 1.5 before the SLT and 0.59 afterwards (p < 0.001). The most common complications after SLT were anterior chamber inflammation in 29 cases (63.04%), hyperemia in 20 (43.40%) cases (4.34%), an early period IOP increase of 5 mmHg or more in 11 cases (23.91%), and mild ocular pain in 2 cases (4.34%).
Conclusion
SLT is an effective and reliable method for JOAG treatment.
Similar content being viewed by others
References
European Glaucoma Society (2008) Terminology and guidelines for glaucoma, 3rd edn (2.2.1), p 95
Kwun Y, Lee EJ, Han JC, Kee C (2016) Clinical characteristics of Juvenile-onset open angle glaucoma. Korean J Ophthalmol 30(2):127–133
Goldwyn R, Waltman SR, Becker B (1970) Primary open-angle glaucoma in adolescents and young adults. Arch Ophthalmol 84(5):579–582
Marshall LL, Hayslett RL, Stevens GA (2018) Therapy for open-angle glaucoma. Consult Pharm 33(8):432–445
Chardoub AAJ, Blair K (2022) Juvenile glaucoma. StatPearls Publishing
Talbot AW, Russel-Eggit I (2000) Pharmaceutical management of the childhood glaucomas. Expert Opin Pharmacother 1(4):697–711
Wiggs JL, Del Bono EA, Schuman JS, Hutchinson BT, Walton DS (1995) Clinical features of five pedigrees genetically linked to the juvenile glaucoma locus on chromosome 1q21-q31. Ophthalmology 102(12):1782–1789
Johnson AT, Drack AV, Kwitek AE, Cannon RL, Stone EM, Alward WL (1993) Clinical features and linkage analysis of a family with autosomal dominant juvenile glaucoma. Ophthalmology 100(4):524–529
Ikeda H, Ishigooka H, Muto T, Tanihara H, Nagata M (2004) Long-term outcome of trabeculotomy for the treatment of developmental glaucoma. Arch Ophthalmol 122(8):1122–1128
Pathania D, Senthil S, Rao HL, Mandal AK, Garudadari CS (2014) Outcomes of trabeculectomy in juvenile open angle glaucoma. Indian J Ophthalmol 62(2):224–228
Tsai JC, Chang HW, Kao CN, Lai IC, Teng MC (2003) Trabeculectomy with mitomycin C versus trabeculectomy alone for juvenile primary open-angle glaucoma. Ophthalmologica 217(1):24–30
Mark A, Latina MD, Joseph AJ, Tumbocon MD (2002) Selective laser trabeculoplasty: a new treatment option for open angle glaucoma. Curr Opinion Ophthalmol 13:94–96
Stangos AN, Whatham AR, Sunaric-Megevand G (2005) Primary viscocanalostomy for juvenile open-angle glaucoma. Am J Ophthalmol 140(3):490–496
Congdon N, Azuara-Blanco A, Solberg Y et al (2021) Direct selective laser trabeculoplasty in open angle glaucoma study design: a multicentre, randomised, controlled, investigator-masked trial (GLAUrious). Br J ophthalmol 0:1–4
Agarwal HC, Sihota R, Das C, Dada T (2002) Role of argon laser trabeculoplasty as primary and secondary therapy in open angle glaucoma in Indian patients. Br J Ophthalmol 86:733–736
Ansari E (2021) 10-year outcomes of first-line selective laser trabeculoplasty (SLT) for primary open-angle glaucoma (POAG). Graefe’s Arch Clin Exp Ophthalmol 259:1597–1604
Ticho U, Nesher R (1989) Laser trabeculoplasty in glaucoma: ten-year evaluation. Arch Ophthalmol 107:844–846
Investigators AGIS (2002) The advanced glaucoma intervention study (AGIS), 11: risk factors for failure of trabeculectomy and argon laser trabeculoplasty. Am J Ophthalmol 134:481–498
The Glaucoma Laser Trial Research Group (1995) The Glaucoma Laser Trial (GLT) and glaucoma laser trial follow-up study, seven-year results. Am J Ophthalmol 120:718–731
Latina M, Park C (1995) Selective targeting of trabecular meshwork cells: in vitro studies of pulse and continuous laser interactions. Exp Eye Res 60:359–372
Kramer TR, Noecker RJ (2001) Comparison of the morphologic changes after selective laser trabeculoplasty in human eye bank eyes. Ophthalmology 108:773–779
Kun Hong B, Winer JC, Martone JF et al (2009) Repeat selective laser trabeculoplasty. J Glaucoma 18(3):180–183
Eyawo O, Lee C-W, Rachlis B et al (2008) Reporting of noninferiority and equivalence randomized trials for major prostaglandins: a systematic survey of the ophthalmology literature. Trials 9:69
Latina MA, Sibayan SA, Shin DH et al (1998) Q-switched 532-nm Nd:YAG laser trabeculoplasty (selective laser trabeculoplasty): a multicenter, pilot, clinical study. Ophthalmology 105:2082–2090
Woo DM, Healey PR, Graham SL (2015) Intraocular pressure-lowering medications and long term outcomes of selective laser trabeculoplasty: glaucoma laser and medical therapy. Clin Exp Ophthalmol 43:320–327
El Mallah MK, Walsh MM, Stinnett SS et al (2010) Selective laser trabeculoplasty reduces mean IOP and IOP variation in normal tension glaucoma patients. Clin Ophthalmol 4:889–893
Pan YI, Damji KF, Rock W et al (2004) Highly successful SLT is independent of glaucoma risk factors. Invest Ophthalmol Vis Sci 45:4456
Hodge WG, Damji KF, Rock W et al (2005) Baseline IOP predicts selective laser trabeculoplasty success at 1 year post-treatment: results from a randomised clinical trial. Br J Ophthalmol 89:1157–1160
Goldmann H, Schmidt T (1957) Applanation tonometry. Ophthalmologica 134:221–242
Mills RP, Budenz DL, Lee PP et al (2006) Categorizing the stageof glaucoma from pre-diagnosis to end-stage disease. Am J Ophthalmol 141:24–30
Spaeth GL (1971) The normal development of the human anterior chamber angle: a new system of descriptive grading. Trans Ophthalmol Soc UK 91:709–739
Leahy KE, White AJ (2015) Selective laser trabeculoplasty: current perspectives. Clin Ophthalmol 11:833–841
Song J, Song A, Palmares T, Song M (2013) Selective laser trabeculoplasty success in pediatric patients with glaucoma: two case reports. J Med Case Rep 7:198
Lui Y, Birt CM (2012) Argon versus selective laser trabeculoplasty in younger patients: 2-years results. J Glaucoma 21:112–115
Gupta V, Ghosh S, Chaudhary S et al (2018) Selective laser trabeculoplasty for primary open-angle glaucoma patients younger than 40 years. Can J Ophthalmol 53(1):81–85
Lui D, Chen D, Tan Q et al (2020) Outcome of selective laser trabeculoplasty in young patients with primary open-angle glaucoma and ocular hypertension. J Ophthalmol 8:1–6
Baser EF, Akbulut D (2015) Significant peripheral anterior synechiae after repeat selective laser trabeculoplasty. Can J Ophthalmol 50(3):36–38
Weinnand FS, Althen F (2006) Long-term clinical results of selective laser trabeculoplasty in the treatment of primary open angle glaucoma. Eur J Ophthalmol 16:100–104
Schlote T, Kynigopoulos M (2016) Selective laser trabeculoplasty: 1 year results in early and advanced open angle glaucoma. Int Ophthalmol 365:55–61
Francis BA, Ianchulev T, Schofield JK et al (2005) Selective laser trabeculoplasty as a replacement for medical therapy in open-angle glaucoma. Am J Ophthalmol 140:524–525
Lee JW, Chan CV, Wong MO et al (2014) A randomized control trial to evaluate the effect of adjuvant selective laser trabeculoplasty versus medication alone in primary open-angle glaucoma: preliminary results. Clin Ophthalmol 8:1987–1992
Lee R, Hutnik VML (2006) Projected cost comparison of selective laser trabeculoplasty versus glaucoma medication in the Ontario Health Insurance Plan. Can J Ophthalmol 41:449–456
Wong MO, Lee JW, Choy BN et al (2015) Systemic review and meta-analysis on the efficacy of selective laser trabeculoplasty in open-angle glaucoma. Surv Ophthalmol 60:36–50
Song J (2016) Complications of selective laser trabeculoplasty: a review. Clin Ophthalmol 10:137–143
Rhodes KM, Weinstein R, Saltzmann RM et al (2009) Intra ocular pressure reduction in the untreated fellow eye after selective laser trabeculoplasty. Curr Med Res Opin 25:787–796
Kara N, Altınkaynak H, Şatana B et al (2011) Evaluation of factors influencing outcomes of selective laser trabeculoplasty in primary open angle glaucoma. Turk J Ophthalmol 41:304–308
Funding
None.
Author information
Authors and Affiliations
Contributions
It is a single-authored study.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no competing interests.
Ethical approval
Bezmialem Foundation University Non-Interventional Research Ethics Committee (Bezmialem Vakıf Üniversitesi Rektörlüğü Teknoloji Transfer Ofisi Etik Kurullar Birimi) 11.05.2023-106959.
Patient consent
Consent was obtained from the patients themselves for those over 18 years and from the parents for younger patients.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Kurnaz, E. Selective laser trabeculoplasty in the treatment of juvenile open angle glaucoma patients under 25 years of age. Int Ophthalmol 44, 201 (2024). https://doi.org/10.1007/s10792-024-03108-7
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s10792-024-03108-7