SLT: Evaluation of the Efficacy of Selecta Laser Trabeculoplasty in Patients Undergoing Filtering Surgery
Study Details
Study Description
Brief Summary
Glaucoma is a common, potentially blinding pathology, threatening patients' autonomy and quality of life. The main aim of treatment is to lower intraocular pressure (IOP) in order to slow nerve fiber loss as much as possible, leading to alterations in the visual field and even reduced visual acuity. To achieve this drop in pressure, there are, of course, hypotonizing eye drops, trabeculoplasty with Laser Selecta (SLT) or filtering surgery (trabeculectomy, deep non-perforating sclerectomy, insertion of drainage devices). Laser Selecta specifically targets pigmented trabecular meshwork cells without damaging adjacent structures, and is thought to act via three mechanisms: distension of Schlemm's canal, reorganization of trabecular meshwork cells and stimulation of extracellular matrix production. Its efficacy has been demonstrated in several studies, with a 20-30% reduction in intraocular pressure in patients who have never undergone surgery. Few studies have investigated the efficacy of SLT in patients who have already undergone filtering surgery. The aim of this study is therefore to determine the efficacy of SLT in previously operated patients whose intraocular pressure remains insufficiently controlled.
| Condition or Disease | Intervention/Treatment | Phase |
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Study Design
Outcome Measures
Primary Outcome Measures
- Decrease of 20% or more of the intraocular pressure after surgery [12 months]
Intraocular pressure is measured before procedure , 1 month, 6months and 12 months after procedure
Secondary Outcome Measures
- Average Decrease of the intraocular pressure after procedure depending of the initial IOP [12 months]
Intraocular pressure is measured before procedure , 1 month, 6months and 12 months. average IOP decrease is calculated for the group of patients with an initial IOP >21mmHg and for the group with an initial IOP<21mmHg
- Average Decrease of the intraocular pressure after procedure depending on the delay between filtering surgery and the Selecta Laser procedure. [12 months]
Intraocular pressure is measured before procedure , 1 month, 6months and 12 months. average IOP decrease is calculated for the group of patients with a less than 1 year between filtering surgery and SLT , the group with a period of 1 to 5 years between filtering surgery and SLT and the group with more than 5 year inbetween.
- Average Decrease of the intraocular pressure after procedure depending on the type of filtering surgery [12 months]
Intraocular pressure is measured before procedure , 1 month, 6months and 12 months. average IOP decrease is calculated for each type of filtering surgery : trabeculectomy or, deep non-perforating sclerectomy, or insertion of drainage devices
- Average Decrease of the intraocular pressure after procedure depending on the type of glaucoma [12 months]
Intraocular pressure is measured before procedure , 1 month, 6months and 12 months. average IOP decrease is calculated for each type of glaucoma : primary open-angle glaucoma, or exfoliative glaucoma or pigmentary glaucoma
Eligibility Criteria
Criteria
Inclusion Criteria:
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Patients aged ≥ 18 years
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Patients who have undergone filtering surgery such as trabeculectomy, deep non-perforating sclerectomy, or placement of a Xen®-type device
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Patients who have undergone laser SLT
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Patient with primary open-angle glaucoma, exfoliative glaucoma or pigmentary glaucoma
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Insufficiently controlled intraocular pressure.
Exclusion Criteria: - Patients under guardianship or curatorship
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Patient deprived of liberty
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Patient objecting to the use of his or her data for this research
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Patient with angle-closure glaucoma
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Patient having undergone any other type of eye surgery except cataract surgery
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Groupe Hospitalier Paris Saint Joseph | Paris | Ile-de-France | France | 75014 |
Sponsors and Collaborators
- Groupe Hospitalier Paris Saint Joseph
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- Latina MA, Park C. Selective targeting of trabecular meshwork cells: in vitro studies of pulsed and CW laser interactions. Exp Eye Res. 1995 Apr;60(4):359-71. doi: 10.1016/s0014-4835(05)80093-4.
- Nagar M, Luhishi E, Shah N. Intraocular pressure control and fluctuation: the effect of treatment with selective laser trabeculoplasty. Br J Ophthalmol. 2009 Apr;93(4):497-501. doi: 10.1136/bjo.2008.148510. Epub 2008 Dec 23.
- Sharpe RA, Kammerdiener LL, Williams DB, Das SK, Nutaitis MJ. Efficacy of selective laser trabeculoplasty following incisional glaucoma surgery. Int J Ophthalmol. 2018 Jan 18;11(1):71-76. doi: 10.18240/ijo.2018.01.13. eCollection 2018.
- Zhang H, Yang Y, Xu J, Yu M. Selective laser trabeculoplasty in treating post-trabeculectomy advanced primary open-angle glaucoma. Exp Ther Med. 2016 Mar;11(3):1090-1094. doi: 10.3892/etm.2015.2959. Epub 2015 Dec 29.
- SLT