Selective laser trabeculoplasty for primary angle closure with persistently elevated intraocular pressure after iridotomy.

Purpose

To determine whether selective laser trabeculoplasty (SLT) can lower intraocular pressure (IOP) in eyes with chronic primary angle closure, elevated IOP, and a patent iridotomy.

Patients and methods: Patients with chronic angle closure who had underwent iridotomy, had an IOP greater than 21 mm Hg and a gonioscopically visible pigmented trabecular meshwork for at least 90 degrees were enrolled. SLT was applied to open angle segments. Duration of follow-up was 6 months.

Results

Sixty eyes of 60 patients were enrolled. The mean baseline IOP was 24.6+/-2.5 mm Hg. At 6 months, IOP reduction of > or =3 mm Hg or 4 mm Hg was measured in 82% and 72% of eyes, respectively, and IOP reduction of > or =20% or 30% was measured in 54% and 24% of eyes, respectively. When only eyes that were treated with the same number or fewer medications were considered, these IOP reductions were measured in 67%, 58%, 43%, and 15%, respectively. During the study period 1 eye (1.7%) required trabeculectomy owing to IOP elevation shortly after the SLT. There were no other significant complications attributable to SLT.

Conclusions

SLT seems to be a safe and effective method of reducing IOP in many eyes with primary angle closure and a patent iridotomy in which there is a sufficient extent of visible trabecular meshwork.