TY - JOUR
T1 - Gonioscopic Ab Interno Laser Sclerostomy
T2 - A Pilot Study in Glaucoma Patients
AU - Latina, Mark A.
AU - Melamed, Shlomo
AU - March, Wayne F.
AU - Kass, Michael A.
AU - Kolker, Allan E.
N1 - Funding Information:
Originally received: October 13, 1991. Revision accepted: May 1, 1992. I Wellman Laboratories, Massachusetts General Hospital, Boston. 2 Goldschleger Eye Institute, Cahin Shiba Medical Center, Tel-Hashomer, Israel. 3 University of Texas, School of Medicine, Galveston. 4 Washington University School of Medicine, St. Louis. Presented in part at the American Academy of Ophthalmology Annual Meeting, Anaheim, October 1991. Supported in part by Candela Laser Inc, Wayland, Massachusetts. A United States patent has been filed and assigned to the Massachusetts General Hospital by Mark A. Latina, MD. Reprint requests to Mark A. Latina, MD, Wellman Laboratories, Second Roor, Massachusetts General Hospital, Boston, MA 02114.
PY - 1992
Y1 - 1992
N2 - Purpose: The purpose of this study is to evaluate the safety and efficacy of gonioscopic ab interno laser sclerostomy (GLS) in patients with glaucoma. Methods: The technique of GLS involves iontophoresis of methylene blue dye (1 %) at the limbus to focally dye the sclera and to provide subsequent delivery of 10-μsec pulsed laser energy to the dyed area through a goniolens. The laser emits at 660 nm, a wavelength that is maximally absorbed by the methylene blue dye. Patients were evaluated for fistula formation, intraocular pressure (IOP) reduction, and adverse sequelae. Thirty-eight treatments were performed in 35 eyes. Results: Successful complete sclerostomies were achieved in 21 eyes (55%), which was associated with an acute mean reduction in IOP of 23 mmHg. Mean preoperative IOP for all patients was 35 mmHg, and 1 hour after treatment it was reduced to 18.5 mmHg. In 4 of the 38 treatments, there was no acute IOP reduction, and these eyes were judged as failures. The mean follow-up time was 8.2 months with a maximum follow-up of 15 months. By 9 months, 50% of patients had an IOP of 22 mmHg or lower. The number of antiglaucoma medications decreased from 3.1 to 1.7 for all eyes over the 15-month follow-up period. Hyphemas (13%) were the only major complication, and these resolved spontaneously. In only one case did the IOP increase after the procedure. Conclusion: The results of this trial indicate that GLS is technically feasible, and preliminary results of IOP control are promising.
AB - Purpose: The purpose of this study is to evaluate the safety and efficacy of gonioscopic ab interno laser sclerostomy (GLS) in patients with glaucoma. Methods: The technique of GLS involves iontophoresis of methylene blue dye (1 %) at the limbus to focally dye the sclera and to provide subsequent delivery of 10-μsec pulsed laser energy to the dyed area through a goniolens. The laser emits at 660 nm, a wavelength that is maximally absorbed by the methylene blue dye. Patients were evaluated for fistula formation, intraocular pressure (IOP) reduction, and adverse sequelae. Thirty-eight treatments were performed in 35 eyes. Results: Successful complete sclerostomies were achieved in 21 eyes (55%), which was associated with an acute mean reduction in IOP of 23 mmHg. Mean preoperative IOP for all patients was 35 mmHg, and 1 hour after treatment it was reduced to 18.5 mmHg. In 4 of the 38 treatments, there was no acute IOP reduction, and these eyes were judged as failures. The mean follow-up time was 8.2 months with a maximum follow-up of 15 months. By 9 months, 50% of patients had an IOP of 22 mmHg or lower. The number of antiglaucoma medications decreased from 3.1 to 1.7 for all eyes over the 15-month follow-up period. Hyphemas (13%) were the only major complication, and these resolved spontaneously. In only one case did the IOP increase after the procedure. Conclusion: The results of this trial indicate that GLS is technically feasible, and preliminary results of IOP control are promising.
UR - http://www.scopus.com/inward/record.url?scp=0026475428&partnerID=8YFLogxK
U2 - 10.1016/S0161-6420(92)31738-5
DO - 10.1016/S0161-6420(92)31738-5
M3 - Article
C2 - 1454351
AN - SCOPUS:0026475428
SN - 0161-6420
VL - 99
SP - 1736
EP - 1744
JO - Ophthalmology
JF - Ophthalmology
IS - 11
ER -