Current review of Excimer laser Trabeculostomy.
- Durr GM 1Department of Ophthalmology, Université de Montréal, Montreal, Quebec Canada.
- Töteberg-Harms M 3Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland.
- Lewis R Sacramento Eye Consultants, Sacramento, California USA.
- Fea A 5Struttura Complessa Oculistica, Città della Salute e della Scienza di Torino, Dipartimento di Scienze Chirurgiche, Università degli Studi di Torino, Torino, Italy.
- Marolo P 5Struttura Complessa Oculistica, Città della Salute e della Scienza di Torino, Dipartimento di Scienze Chirurgiche, Università degli Studi di Torino, Torino, Italy.
- Ahmed IIK 6Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario Canada.
- 2020-05-12
Published in:
- Eye and vision (London, England). - 2020
English
Background
Excimer laser trabeculostomy (ELT) is a microinvasive glaucoma surgery (MIGS) that creates multiple laser channels through the trabecular meshwork using a cold laser system, which minimizes tissue fibrosis and aids in bypassing the main area of resistance to aqueous outflow. The purpose of this review is to evaluate the current body of evidence surrounding ELT in terms of efficacy and review the safety profile of the procedure.
Main text
Studies screened had to show clear inclusion and exclusion criteria as well as well-defined outcome measures. PubMed, MEDLINE, EMBASE and the Cochrane Controlled Trial Database were searched. Preferred Reporting Items of Systematic Reviews (PRISMA) guidelines were used to assess for study quality and for any bias. Sixty-four articles were initially identified with 18 meeting preliminary screening criteria. Ultimately, 8 studies met inclusion criteria and 2 additional non-referenced publications were also included: 1 randomized control trial, 4 prospective case series and 5 retrospective studies. Overall studies showed moderate intraocular pressure (IOP) lowering of between 20% and 40% from baseline without medication washout and mostly a decrease in glaucoma medications with few complications.
Conclusion
Current literature shows a significant IOP-lowering effect of ELT with a favorable safety-profile in standalone cases or combined with cataract surgery. Limitations to these studies are the lack of controls and washout IOP. Overall, ELT is an attractive MIGS option that does not require any residual device remaining in the angle.
Excimer laser trabeculostomy (ELT) is a microinvasive glaucoma surgery (MIGS) that creates multiple laser channels through the trabecular meshwork using a cold laser system, which minimizes tissue fibrosis and aids in bypassing the main area of resistance to aqueous outflow. The purpose of this review is to evaluate the current body of evidence surrounding ELT in terms of efficacy and review the safety profile of the procedure.
Main text
Studies screened had to show clear inclusion and exclusion criteria as well as well-defined outcome measures. PubMed, MEDLINE, EMBASE and the Cochrane Controlled Trial Database were searched. Preferred Reporting Items of Systematic Reviews (PRISMA) guidelines were used to assess for study quality and for any bias. Sixty-four articles were initially identified with 18 meeting preliminary screening criteria. Ultimately, 8 studies met inclusion criteria and 2 additional non-referenced publications were also included: 1 randomized control trial, 4 prospective case series and 5 retrospective studies. Overall studies showed moderate intraocular pressure (IOP) lowering of between 20% and 40% from baseline without medication washout and mostly a decrease in glaucoma medications with few complications.
Conclusion
Current literature shows a significant IOP-lowering effect of ELT with a favorable safety-profile in standalone cases or combined with cataract surgery. Limitations to these studies are the lack of controls and washout IOP. Overall, ELT is an attractive MIGS option that does not require any residual device remaining in the angle.
- Language
-
- English
- Open access status
- gold
- Identifiers
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- DOI 10.1186/s40662-020-00190-7
- PMID 32391398
- Persistent URL
- https://sonar.ch/global/documents/195596
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