Micropulse diode laser trabeculoplasty (MDLT): A phase II clinical study with 12 months follow-up

Antonio Maria Fea, Alex Bosone, Teresa Rolle, Beatrice Brogliatti, Federico Maria GrignoloIstituto di Fisiopatologia Clinica, Clinica Oculistica dell&rsquo; Universit&agrave; di Torino, Torino, ItalyObjective: This pilot study evaluates the pressure lowering potential of subthreshold...

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Autores principales:	Antonio Maria Fea, Alex Bosone, Teresa Rolle, Beatrice Brogliatti, Federico Maria Grignolo
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2008
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/320e59d1a41c46ab8c9aa34d245b512c
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spelling	oai:doaj.org-article:320e59d1a41c46ab8c9aa34d245b512c2021-12-02T06:51:32ZMicropulse diode laser trabeculoplasty (MDLT): A phase II clinical study with 12 months follow-up1177-54671177-5483https://doaj.org/article/320e59d1a41c46ab8c9aa34d245b512c2008-06-01T00:00:00Zhttp://www.dovepress.com/micropulse-diode-laser-trabeculoplasty-mdlt-a-phase-ii-clinical-study--a1776https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Antonio Maria Fea, Alex Bosone, Teresa Rolle, Beatrice Brogliatti, Federico Maria GrignoloIstituto di Fisiopatologia Clinica, Clinica Oculistica dell&rsquo; Universit&agrave; di Torino, Torino, ItalyObjective: This pilot study evaluates the pressure lowering potential of subthreshold micropulse diode laser trabeculoplasty (MDLT) for a clinically meaningful duration in patients with medically uncontrolled open angle glaucoma (OAG).Design: prospective interventional case series.Participants: Thirty-two eyes of 20 consecutive patients with uncontrolled OAG (12 bilateral and 8 unilateral).Methods: Confluent subthreshold laser applications over the inferior 180&deg; of the anterior TM using an 810 nm diode laser in a micropulse operating mode. The intraocular pressure (IOP) was measured at baseline and at 1 hour, 1 day, 1 week, 3, 6, 9, and 12 months post-treatment. Flare was measured with a Kowa FM 500 flare-meter at baseline and at 3 hours, 1 day, 1 week, and 12 months post-treatment. After treatment, the patients were maintained on their pre-treatment drug regimen.Main outcome measures: Criteria for treatment response were IOP reduction &ge;3 mm Hg and IOP &le;21 mm Hg within the first week after MDLT. Eyes not complying to the above criteria during the follow-up were considered treatment failure. Mean IOP change and percentage of IOP reduction during the follow-up were calculated.Results: One eye was analyzed for bilateral patients. A total of 20 eyes were thus included. Four eyes (20%) did not respond to treatment during the first week. One additional eye failed at the 6 month visit. The treatment was successful in 15 eyes (75%) at 12 months. The IOP was significantly lower throughout follow-up (p &lt; 0.01). At 12 months, the mean percentage of IOP reduction in the 15 respondent eyes was 22.1% and 12 eyes (60%) had IOP reduction higher than 20%. During the first two postoperative days, one eye with pigmentary glaucoma experienced a significant increase of flare associated with an IOP spike (34 mm Hg) that was controlled with systemic drugs; afterwards it qualified as a respondent and completed the study. No increase of flare was found in any other patient. No peripheral anterior synechiae formed.Conclusions: In this case series, MDLT was effective in reducing IOP in 75% of medically insufficiently controlled OAG eyes without significant complications. This justifies randomized clinical studies to compare MDLT with current IOP lowering strategies.Keywords: open angle glaucoma, trabeculoplasty, diode laser, micropulse, subthreshold Antonio Maria FeaAlex BosoneTeresa RolleBeatrice BrogliattiFederico Maria GrignoloDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2008, Iss Issue 2, Pp 247-252 (2008)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Antonio Maria Fea Alex Bosone Teresa Rolle Beatrice Brogliatti Federico Maria Grignolo Micropulse diode laser trabeculoplasty (MDLT): A phase II clinical study with 12 months follow-up
description	Antonio Maria Fea, Alex Bosone, Teresa Rolle, Beatrice Brogliatti, Federico Maria GrignoloIstituto di Fisiopatologia Clinica, Clinica Oculistica dell&rsquo; Universit&agrave; di Torino, Torino, ItalyObjective: This pilot study evaluates the pressure lowering potential of subthreshold micropulse diode laser trabeculoplasty (MDLT) for a clinically meaningful duration in patients with medically uncontrolled open angle glaucoma (OAG).Design: prospective interventional case series.Participants: Thirty-two eyes of 20 consecutive patients with uncontrolled OAG (12 bilateral and 8 unilateral).Methods: Confluent subthreshold laser applications over the inferior 180&deg; of the anterior TM using an 810 nm diode laser in a micropulse operating mode. The intraocular pressure (IOP) was measured at baseline and at 1 hour, 1 day, 1 week, 3, 6, 9, and 12 months post-treatment. Flare was measured with a Kowa FM 500 flare-meter at baseline and at 3 hours, 1 day, 1 week, and 12 months post-treatment. After treatment, the patients were maintained on their pre-treatment drug regimen.Main outcome measures: Criteria for treatment response were IOP reduction &ge;3 mm Hg and IOP &le;21 mm Hg within the first week after MDLT. Eyes not complying to the above criteria during the follow-up were considered treatment failure. Mean IOP change and percentage of IOP reduction during the follow-up were calculated.Results: One eye was analyzed for bilateral patients. A total of 20 eyes were thus included. Four eyes (20%) did not respond to treatment during the first week. One additional eye failed at the 6 month visit. The treatment was successful in 15 eyes (75%) at 12 months. The IOP was significantly lower throughout follow-up (p &lt; 0.01). At 12 months, the mean percentage of IOP reduction in the 15 respondent eyes was 22.1% and 12 eyes (60%) had IOP reduction higher than 20%. During the first two postoperative days, one eye with pigmentary glaucoma experienced a significant increase of flare associated with an IOP spike (34 mm Hg) that was controlled with systemic drugs; afterwards it qualified as a respondent and completed the study. No increase of flare was found in any other patient. No peripheral anterior synechiae formed.Conclusions: In this case series, MDLT was effective in reducing IOP in 75% of medically insufficiently controlled OAG eyes without significant complications. This justifies randomized clinical studies to compare MDLT with current IOP lowering strategies.Keywords: open angle glaucoma, trabeculoplasty, diode laser, micropulse, subthreshold
format	article
author	Antonio Maria Fea Alex Bosone Teresa Rolle Beatrice Brogliatti Federico Maria Grignolo
author_facet	Antonio Maria Fea Alex Bosone Teresa Rolle Beatrice Brogliatti Federico Maria Grignolo
author_sort	Antonio Maria Fea
title	Micropulse diode laser trabeculoplasty (MDLT): A phase II clinical study with 12 months follow-up
title_short	Micropulse diode laser trabeculoplasty (MDLT): A phase II clinical study with 12 months follow-up
title_full	Micropulse diode laser trabeculoplasty (MDLT): A phase II clinical study with 12 months follow-up
title_fullStr	Micropulse diode laser trabeculoplasty (MDLT): A phase II clinical study with 12 months follow-up
title_full_unstemmed	Micropulse diode laser trabeculoplasty (MDLT): A phase II clinical study with 12 months follow-up
title_sort	micropulse diode laser trabeculoplasty (mdlt): a phase ii clinical study with 12 months follow-up
publisher	Dove Medical Press
publishDate	2008
url	https://doaj.org/article/320e59d1a41c46ab8c9aa34d245b512c
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Micropulse diode laser trabeculoplasty (MDLT): A phase II clinical study with 12 months follow-up

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