SLT without gonioscopy lens successful

Orlando-Selective laser trabeculoplasty (SLT) without the use of a gonioscopy lens was performed successfully and still decreased IOP over 6 months, said Michael Belkin, MD.

Dr. Belkin, of the Goldschleger Eye Research Institute, Tel-Aviv University, Tel-Hashomer, Israel, highlighted his results during a session on glaucoma surgery, wound healing, and lasers at the 2014 meeting of the Association for Research in Vision and Ophthalmology.

In his study, a control group of 16 patients had conventional SLT with 100 laser spots through a gonioscope for 360° directly on the trabecular meshwork. A trial group had irridation performed by the same laser and with the same irridation parameters but without the gonioscope. All surgeries were performed by the same surgeon, Dr. Belkin said.

Patients did not have a change in their topical glaucoma therapy during the 6-month study period.

In the trial group, the average IOP decreased from 20.21 to 15.50 mm Hg at 6 months. In the control group, the IOP at 6 months dropped from 21.14 to 15 mm Hg. The IOP reduction difference between the two groups was not statistically significant, Dr. Belkin noted.

The control group had significantly higher complications as well as higher anterior chamber inflammation and superficial punctate keratitis rates.

“You don’t need the gonioscopy lens to do SLT,” Dr. Belkin said. “Transscleral SLT is as efficacious as traditional SLT and it lowers corneal- and gonioscopy-induced side effects.”

Eliminating the use of the gonioscope in SLT could provide wider access to the procedure among physicians, Dr. Belkin said.

Additionally, although there is not yet research to support it, SLT without use of a gonioscope may open a treatment avenue for angle-closure glaucoma, he added.

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