November 04, 2013
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SLT not useful after failed phaco, ab interno trabeculectomy

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Selective laser trabeculoplasty failed after unsuccessful phacoemulsification with ab interno trabeculectomy, according to a small study.

The randomized, interventional case series retrospectively analyzed the medical records of 14 eyes of 13 patients who underwent SLT after failed phaco with ab interno trabeculectomy using the Trabectome (NeoMedix) between March 2010 and July 2012.

Patients were followed for a mean 12.9 months after SLT.

The number of antiglaucoma medications was 2.8 at baseline, and baseline IOP was 17.9 mm Hg.

SLT failed in all cases, with a median failure time of 3.6 months after the procedure.

There was no difference between preop and postop in the number of antiglaucoma medications. There was a limited duration of significant IOP lowering.

“We recommend that after phaco-Trabectome fails, one should strongly consider incisional filtration surgery and not selective laser trabeculoplasty,” the study authors said.

Disclosure: Töteberg-Harms receives funding by the Swiss National Science Foundation. Rhee receives research funding from Alcon, AqueSys and Merck and is an ad hoc consultant for Aerie, Alcon, Allergan, AqueSys, Merck and Santen.