Current review of Excimer laser Trabeculostomy
Abstract Background Excimer laser trabeculostomy (ELT) is a microinvasive glaucoma surgery (MIGS) that creates multiple laser channels through the trabecular meshwork using a cold laser system, which minimizes tissue fibrosis and aids in bypassing the main area of resistance to aqueous outflow. The...
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | Eye and Vision |
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| Online Access: | http://link.springer.com/article/10.1186/s40662-020-00190-7 |
| _version_ | 1811225752235933696 |
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| author | Georges M. Durr Marc Töteberg-Harms Richard Lewis Antonio Fea Paola Marolo Iqbal Ike K. Ahmed |
| author_facet | Georges M. Durr Marc Töteberg-Harms Richard Lewis Antonio Fea Paola Marolo Iqbal Ike K. Ahmed |
| author_sort | Georges M. Durr |
| collection | DOAJ |
| description | Abstract Background Excimer laser trabeculostomy (ELT) is a microinvasive glaucoma surgery (MIGS) that creates multiple laser channels through the trabecular meshwork using a cold laser system, which minimizes tissue fibrosis and aids in bypassing the main area of resistance to aqueous outflow. The purpose of this review is to evaluate the current body of evidence surrounding ELT in terms of efficacy and review the safety profile of the procedure. Main text Studies screened had to show clear inclusion and exclusion criteria as well as well-defined outcome measures. PubMed, MEDLINE, EMBASE and the Cochrane Controlled Trial Database were searched. Preferred Reporting Items of Systematic Reviews (PRISMA) guidelines were used to assess for study quality and for any bias. Sixty-four articles were initially identified with 18 meeting preliminary screening criteria. Ultimately, 8 studies met inclusion criteria and 2 additional non-referenced publications were also included: 1 randomized control trial, 4 prospective case series and 5 retrospective studies. Overall studies showed moderate intraocular pressure (IOP) lowering of between 20% and 40% from baseline without medication washout and mostly a decrease in glaucoma medications with few complications. Conclusion Current literature shows a significant IOP-lowering effect of ELT with a favorable safety-profile in standalone cases or combined with cataract surgery. Limitations to these studies are the lack of controls and washout IOP. Overall, ELT is an attractive MIGS option that does not require any residual device remaining in the angle. |
| first_indexed | 2024-04-12T09:12:43Z |
| format | Article |
| id | doaj.art-7f94aa4a26504e728109013126a31135 |
| institution | Directory Open Access Journal |
| issn | 2326-0254 |
| language | English |
| last_indexed | 2024-04-12T09:12:43Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Eye and Vision |
| spelling | doaj.art-7f94aa4a26504e728109013126a311352022-12-22T03:38:55ZengBMCEye and Vision2326-02542020-05-01711910.1186/s40662-020-00190-7Current review of Excimer laser TrabeculostomyGeorges M. Durr0Marc Töteberg-Harms1Richard Lewis2Antonio Fea3Paola Marolo4Iqbal Ike K. Ahmed5Department of Ophthalmology, Université de MontréalDepartment of Ophthalmology, University Hospital ZurichSacramento Eye ConsultantsStruttura Complessa Oculistica, Città della Salute e della Scienza di Torino, Dipartimento di Scienze Chirurgiche, Università degli Studi di TorinoStruttura Complessa Oculistica, Città della Salute e della Scienza di Torino, Dipartimento di Scienze Chirurgiche, Università degli Studi di TorinoDepartment of Ophthalmology & Vision Sciences, University of TorontoAbstract Background Excimer laser trabeculostomy (ELT) is a microinvasive glaucoma surgery (MIGS) that creates multiple laser channels through the trabecular meshwork using a cold laser system, which minimizes tissue fibrosis and aids in bypassing the main area of resistance to aqueous outflow. The purpose of this review is to evaluate the current body of evidence surrounding ELT in terms of efficacy and review the safety profile of the procedure. Main text Studies screened had to show clear inclusion and exclusion criteria as well as well-defined outcome measures. PubMed, MEDLINE, EMBASE and the Cochrane Controlled Trial Database were searched. Preferred Reporting Items of Systematic Reviews (PRISMA) guidelines were used to assess for study quality and for any bias. Sixty-four articles were initially identified with 18 meeting preliminary screening criteria. Ultimately, 8 studies met inclusion criteria and 2 additional non-referenced publications were also included: 1 randomized control trial, 4 prospective case series and 5 retrospective studies. Overall studies showed moderate intraocular pressure (IOP) lowering of between 20% and 40% from baseline without medication washout and mostly a decrease in glaucoma medications with few complications. Conclusion Current literature shows a significant IOP-lowering effect of ELT with a favorable safety-profile in standalone cases or combined with cataract surgery. Limitations to these studies are the lack of controls and washout IOP. Overall, ELT is an attractive MIGS option that does not require any residual device remaining in the angle.http://link.springer.com/article/10.1186/s40662-020-00190-7Excimer laser trabeculostomyTrabeculotomyELTIntraocular pressureGlaucomaMIGS |
| spellingShingle | Georges M. Durr Marc Töteberg-Harms Richard Lewis Antonio Fea Paola Marolo Iqbal Ike K. Ahmed Current review of Excimer laser Trabeculostomy Eye and Vision Excimer laser trabeculostomy Trabeculotomy ELT Intraocular pressure Glaucoma MIGS |
| title | Current review of Excimer laser Trabeculostomy |
| title_full | Current review of Excimer laser Trabeculostomy |
| title_fullStr | Current review of Excimer laser Trabeculostomy |
| title_full_unstemmed | Current review of Excimer laser Trabeculostomy |
| title_short | Current review of Excimer laser Trabeculostomy |
| title_sort | current review of excimer laser trabeculostomy |
| topic | Excimer laser trabeculostomy Trabeculotomy ELT Intraocular pressure Glaucoma MIGS |
| url | http://link.springer.com/article/10.1186/s40662-020-00190-7 |
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