PDF herunterladen
Klin Monbl Augenheilkd 2019; 236(10): 1192-1200
DOI: 10.1055/a-0577-7925
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Die Lasertrabekuloplastik in der modernen Glaukomtherapie – ein Überblick

Laser Trabeculoplasty in Modern Glaucoma Therapy – a Review
Roman Greslechner
Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg
,
Detlev Spiegel
Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg
› Institutsangaben
Weitere Informationen

Publikationsverlauf

eingereicht 20. November 2017

akzeptiert 06. Februar 2018

Publikationsdatum:
11. April 2018 (online)

Auch verfügbar auf
    Lizenzen und Reprints

Zusammenfassung

Hintergrund Die Lasertrabekuloplastik (LTP) stellt neben medikamentöser Therapie und operativen Interventionen eine etablierte Behandlungsmodalität in der Therapie chronischer Offenwinkelglaukome dar. Dabei besteht eine große Variabilität in der praktischen Anwendung.

Methoden Literaturrecherche über PubMed. Darstellung der wichtigsten evidenzbasierten Daten zur Lasertrabekuloplastik.

Ergebnisse Argonlasertrabekuloplastik (ALT) und selektive Lasertrabekuloplastik (SLT) stellen sichere und effektive Verfahren dar, die zu einer Drucksenkung um 20 – 30% führen. Vergleichbare Erfolgsraten werden für beide Prozeduren berichtet. Im Verlauf muss bei 50% mit einem Therapieversagen nach ca. 2 – 5 Jahren gerechnet werden. Die Wiederholung einer ALT ist mit einer deutlich geringeren Drucksenkung und Wirkdauer verbunden. Auch die Wiederholung einer SLT ist mit einem Wirkverlust verbunden. Die Wirksamkeit der SLT nach initialer ALT konnte nachgewiesen werden, wohingegen Daten zur Wirksamkeit einer ALT nach initialer SLT noch fehlen. Bei fortgeschrittenen Glaukomen unter maximaler medikamentöser Therapie wurden in Hinblick auf zusätzliche Interventionen schlechtere Erfolgsraten berichtet.

Schlussfolgerung Die LTP bietet sich als Ersttherapie und ergänzende Therapie in allen Stadien an. Bei fortgeschrittenen Glaukomen unter maximaler medikamentöser Therapie sind die Erfolgsaussichten aufgrund der notwendigen niedrigen Zieldrücke eingeschränkt.

Abstract

Background Laser trabeculoplasty (LTP) is a well established treatment modality in the management of chronic open angle glaucoma. Nonetheless there is much variation in practice.

Methods A literature search in the PubMed database was conducted and the most important evidence-based results were summarised.

Results Argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT) are safe and effective treatment modalities, achieving an IOP reduction of 20 – 30%. Similar success rates have been reported for both procedures. A 50% rate of failure occurs after 2 – 5 years. Repeat-ALT is associated with a lower IOP decrease and a shorter duration of treatment effect. Repetition of SLT after initial SLT seems to be associated with loss of efficiency as well. SLT has been shown to be successful after initial ALT, whereas there are no data on ALT after initial SLT. For advanced glaucoma on maximum medical therapy, low success rates have been reported with regard to additional interventions.

Conclusion LTP is a good option for initial and adjunctive treatment. In advanced glaucoma on maximum medical therapy, low target pressures are needed, and filtering surgery has to be considered.

Schlüsselwörter

Glaukom - Argonlasertrabekuloplastik - selektive Lasertrabekuloplastik

Key words

glaucoma - argon laser trabeculoplasty - selective laser trabeculoplasty
 

  • Literatur

  • 1 Zweng HC, Flocks M. Experimental photocoagulation of the anterior chamber angle. A preliminary report. Am J Ophthalmol 1961; 52: 163-165
    CrossrefPubMedGoogle Scholar
  • 2 Krasnov MM. [Laser puncture of the anterior chamber angle in glaucoma (a preliminary report)]. Vestn Oftalmol 1972; 3: 27-31
    PubMedGoogle Scholar
  • 3 Worthen DM, Wickham MG. Laser trabeculotomy in monkeys. Invest Ophthalmol 1973; 12: 707-711
    PubMedGoogle Scholar
  • 4 Wise JB, Witter SL. Argon laser therapy for open-angle glaucoma. A pilot study. Arch Ophthalmol 1979; 97: 319-322
    CrossrefPubMedGoogle Scholar
  • 5 The Glaucoma Trail Research Group. The Glaucoma Laser Trial (GLT). 2. Results of argon laser trabeculoplasty versus topical medicines. The Glaucoma Laser Trial Research Group. Ophthalmology 1990; 97: 1403-1413
    CrossrefPubMedGoogle Scholar
  • 6 Latina MA, Park C. Selective targeting of trabecular meshwork cells: in vitro studies of pulsed and CW laser interactions. Exp Eye Res 1995; 60: 359-371
    CrossrefPubMedGoogle Scholar
  • 7 Latina MA, Sibayan SA, Shin DH. et al. Q-switched 532-nm Nd : YAG laser trabeculoplasty (selective laser trabeculoplasty): a multicenter, pilot, clinical study. Ophthalmology 1998; 105: 2082-2088
    CrossrefPubMedGoogle Scholar
  • 8 Cvenkel B, Hvala A, Drnovsek-Olup B. et al. Acute ultrastructural changes of the trabecular meshwork after selective laser trabeculoplasty and low power argon laser trabeculoplasty. Lasers Surg Med 2003; 33: 204-208
    CrossrefPubMedGoogle Scholar
  • 9 Wood JPM, Plunkett M, Previn V. et al. Rapid and delayed death of cultured trabecular meshwork cells after selective laser trabeculoplasty. Lasers Surg Med 2010; 42: 326-337
    CrossrefPubMedGoogle Scholar
  • 10 Melamed S, Pei J, Epstein DL. Short-term effect of argon laser trabeculoplasty in monkeys. Arch Ophthalmol 1985; 103: 1546-1552
    CrossrefPubMedGoogle Scholar
  • 11 Melamed S, Pei J, Epstein DL. Delayed response to argon laser trabeculoplasty in monkeys. Morphological and morphometric analysis. Arch Ophthalmol 1986; 104: 1078-1083
    CrossrefPubMedGoogle Scholar
  • 12 van der Zypen E, Fankhauser F. Ultrastructural changes of the trabecular meshwork of the monkey (Macaca speciosa) following irradiation with argon laser light. Graefes Arch Clin Exp Ophthalmol 1984; 221: 249-261
    CrossrefPubMedGoogle Scholar
  • 13 Mchugh D, Marshall J, Ffytche TJ. et al. Ultrastructural changes of human trabecular meshwork after photocoagulation with a diode laser. Invest Ophthalmol Vis Sci 1992; 33: 2664-2671
    PubMedGoogle Scholar
  • 14 Kramer TR, Noecker RJ. Comparison of the morphologic changes after selective laser trabeculoplasty and argon laser trabeculoplasty in human eye bank eyes. Ophthalmology 2001; 108: 773-779
    CrossrefPubMedGoogle Scholar
  • 15 Wang W, He M, Zhou M. et al. Selective laser trabeculoplasty versus argon laser trabeculoplasty in patients with open-angle glaucoma: a systematic review and meta-analysis. PLoS One 2013; 8: e84270
    CrossrefPubMedGoogle Scholar
  • 16 Van Buskirk EM, Pond V, Rosenquist RC. et al. Argon laser trabeculoplasty. Studies of mechanism of action. Ophthalmology 1984; 91: 1005-1010
    CrossrefPubMedGoogle Scholar
  • 17 Bradley JM, Anderssohn AM, Colvis CM. et al. Mediation of laser trabeculoplasty-induced matrix metalloproteinase expression by IL-1beta and TNFalpha. Invest Ophthalmol Vis Sci 2000; 41: 422-430
    PubMedGoogle Scholar
  • 18 Latina MA, de Leon JMS. Selective laser trabeculoplasty. Ophthalmol Clin North Am 2005; 18: 409-419 vi
    CrossrefPubMedGoogle Scholar
  • 19 Bylsma SS, Samples JR, Acott TS. et al. Trabecular cell division after argon laser trabeculoplasty. Arch Ophthalmol 1988; 106: 544-547
    CrossrefPubMedGoogle Scholar
  • 20 Acott TS, Samples JR, Bradley JM. et al. Trabecular repopulation by anterior trabecular meshwork cells after laser trabeculoplasty. Am J Ophthalmol 1989; 107: 1-6
    CrossrefPubMedGoogle Scholar
  • 21 Bylsma SS, Samples JR, Acott TS. et al. DNA replication in the cat trabecular meshwork after laser trabeculoplasty in vivo. J Glaucoma 1994; 3: 36-43
    PubMedGoogle Scholar
  • 22 Dueker DK, Norberg M, Johnson DH. et al. Stimulation of cell division by argon and Nd : YAG laser trabeculoplasty in cynomolgus monkeys. Invest Ophthalmol Vis Sci 1990; 31: 115-124
    PubMedGoogle Scholar
  • 23 European Glaucoma Society. ed. Terminology and Guidelines for Glaucoma. 4th ed. SvetPrint d.o.o., printed in EU 2014. European Glaucoma Society; 2014
    Google Scholar
  • 24 Habib L, Lin J, Berezina T. et al. Selective laser trabeculoplasty: does energy dosage predict response?. Oman J Ophthalmol 2013; 6: 92-95
    CrossrefPubMedGoogle Scholar
  • 25 Wilensky JT, Weinreb RN. Low-dose trabeculoplasty. Am J Ophthalmol 1983; 95: 423-426
    CrossrefPubMedGoogle Scholar
  • 26 Schwartz LW, Spaeth GL, Traverso C. et al. Variation of techniques on the results of argon laser trabeculoplasty. Ophthalmology 1983; 90: 781-784
    CrossrefPubMedGoogle Scholar
  • 27 Weinreb RN, Ruderman J, Juster R. et al. Influence of the number of laser burns administered on the early results of argon laser trabeculoplasty. Am J Ophthalmol 1983; 95: 287-292
    CrossrefPubMedGoogle Scholar
  • 28 Lustgarten J, Podos SM, Ritch R. et al. Laser trabeculoplasty. A prospective study of treatment variables. Arch Ophthalmol 1984; 102: 517-519
    CrossrefPubMedGoogle Scholar
  • 29 Heijl A. One- and two-session laser trabeculoplasty. A randomized, prospective study. Acta Ophthalmol 1984; 62: 715-724
    PubMedGoogle Scholar
  • 30 Weinreb RN, Ruderman J, Juster R. et al. Immediate intraocular pressure response to argon laser trabeculoplasty. Am J Ophthalmol 1983; 95: 279-286
    CrossrefPubMedGoogle Scholar
  • 31 Elsås T, Johnsen H, Brevik TA. The immediate pressure response to primary laser trabeculoplasty – a comparison of one- and two-stage treatment. Acta Ophthalmol 1989; 67: 664-668
    PubMedGoogle Scholar
  • 32 Goyal S, Beltran-Agullo L, Rashid S. et al. Effect of primary selective laser trabeculoplasty on tonographic outflow facility: a randomised clinical trial. Br J Ophthalmol 2010; 94: 1443-1447
    CrossrefPubMedGoogle Scholar
  • 33 Nagar M, Ogunyomade A, OʼBrart DPS. et al. A randomised, prospective study comparing selective laser trabeculoplasty with latanoprost for the control of intraocular pressure in ocular hypertension and open angle glaucoma. Br J Ophthalmol 2005; 89: 1413-1417
    CrossrefPubMedGoogle Scholar
  • 34 Prasad N, Murthy S, Dagianis JJ. et al. A comparison of the intervisit intraocular pressure fluctuation after 180 and 360 degrees of selective laser trabeculoplasty (SLT) as a primary therapy in primary open angle glaucoma and ocular hypertension. J Glaucoma 2009; 18: 157-160
    CrossrefPubMedGoogle Scholar
  • 35 Tojo N, Oka M, Miyakoshi A. et al. Comparison of fluctuations of intraocular pressure before and after selective laser trabeculoplasty in normal-tension glaucoma patients. J Glaucoma 2014; 23: e138
    CrossrefPubMedGoogle Scholar
  • 36 Robin AL. Argon laser trabeculoplasty medical therapy to prevent the intraocular pressure rise associated with argon laser trabeculoplasty. Ophthalmic Surg 1991; 22: 31-37
    PubMedGoogle Scholar
  • 37 Birt CM, Shin DH, Reed SY. et al. One vs. two doses of 1.0 % apraclonidine for prophylaxis of intraocular pressure spike after argon laser trabeculoplasty. Can J Ophthalmol 1995; 30: 266-269
    PubMedGoogle Scholar
  • 38 David R, Spaeth GL, Clevenger CE. et al. Brimonidine in the prevention of intraocular pressure elevation following argon laser trabeculoplasty. Arch Ophthalmol 1993; 111: 1387-1390
    CrossrefPubMedGoogle Scholar
  • 39 Barnebey HS, Robin AL, Zimmerman TJ. et al. The efficacy of brimonidine in decreasing elevations in intraocular pressure after laser trabeculoplasty. Ophthalmology 1993; 100: 1083-1088
    CrossrefPubMedGoogle Scholar
  • 40 Barnes SD, Campagna JA, Dirks MS. et al. Control of intraocular pressure elevations after argon laser trabeculoplasty: comparison of brimonidine 0.2 % to apraclonidine 1.0 %. Ophthalmology 1999; 106: 2033-2037
    CrossrefPubMedGoogle Scholar
  • 41 Zhang L, Weizer JS, Musch DC. Perioperative medications for preventing temporarily increased intraocular pressure after laser trabeculoplasty. Cochrane Database Syst Rev 2017; (02) CD010746
    PubMedGoogle Scholar
  • 42 [Anonymous] Effect of brimonidine 0.5 % on intraocular pressure spikes following 360 % argon laser trabeculoplasty. The Brimonidine-ALT Study Group. Ophthalmic Surg Lasers 1995; 26: 404-409
    PubMedGoogle Scholar
  • 43 Juzych MS, Chopra V, Banitt MR. et al. Comparison of long-term outcomes of selective laser trabeculoplasty versus argon laser trabeculoplasty in open-angle glaucoma. Ophthalmology 2004; 111: 1853-1859
    CrossrefPubMedGoogle Scholar
  • 44 Baez KA, Spaeth GL. Argon laser trabeculoplasty controls one third of patients with progressive, uncontrolled open-angle glaucoma for five years. Trans Am Ophthalmol Soc 1991; 89: 47-56
    PubMedGoogle Scholar
  • 45 Moulin F, Haut J. Argon laser trabeculoplasty: a 10-year follow-up. Ophthalmologica 1993; 207: 196-201
    CrossrefPubMedGoogle Scholar
  • 46 Bovell AM, Damji KF, Hodge WG. et al. Long term effects on the lowering of intraocular pressure: selective laser or argon laser trabeculoplasty?. Can J Ophthalmol 2011; 46: 408-413
    CrossrefPubMedGoogle Scholar
  • 47 Caprioli J, Coleman AL. Intraocular pressure fluctuation a risk factor for visual field progression at low intraocular pressures in the advanced glaucoma intervention study. Ophthalmology 2008; 115: 1123-1129.e3
    CrossrefPubMedGoogle Scholar
  • 48 Asrani S, Zeimer R, Wilensky J. et al. Large diurnal fluctuations in intraocular pressure are an independent risk factor in patients with glaucoma. J Glaucoma 2000; 9: 134-142
    CrossrefPubMedGoogle Scholar
  • 49 Liu JHK, Kripke DF, Weinreb RN. Comparison of the nocturnal effects of once-daily timolol and latanoprost on intraocular pressure. Am J Ophthalmol 2004; 138: 389-395
    CrossrefPubMedGoogle Scholar
  • 50 Tung JD, Tafreshi A, Weinreb RN. et al. Twenty-four-hour effects of bimatoprost 0.01 % monotherapy on intraocular pressure and ocular perfusion pressure. BMJ Open 2012; 2: e001106
    CrossrefPubMedGoogle Scholar
  • 51 Liu JHK, Medeiros FA, Slight JR. et al. Comparing diurnal and nocturnal effects of brinzolamide and timolol on intraocular pressure in patients receiving latanoprost monotherapy. Ophthalmology 2009; 116: 449-454
    CrossrefPubMedGoogle Scholar
  • 52 Liu JHK, Medeiros FA, Slight JR. et al. Diurnal and nocturnal effects of brimonidine monotherapy on intraocular pressure. Ophthalmology 2010; 117: 2075-2079
    CrossrefPubMedGoogle Scholar
  • 53 Orzalesi N, Rossetti L, Invernizzi T. et al. Effect of timolol, latanoprost, and dorzolamide on circadian IOP in glaucoma or ocular hypertension. Invest Ophthalmol Vis Sci 2000; 41: 2566-2573
    PubMedGoogle Scholar
  • 54 Lee AC, Mosaed S, Weinreb RN. et al. Effect of laser trabeculoplasty on nocturnal intraocular pressure in medically treated glaucoma patients. Ophthalmology 2007; 114: 666-670
    CrossrefPubMedGoogle Scholar
  • 55 Nagar M, Luhishi E, Shah N. Intraocular pressure control and fluctuation: the effect of treatment with selective laser trabeculoplasty. Br J Ophthalmol 2009; 93: 497-501
    CrossrefPubMedGoogle Scholar
  • 56 Richter CU, Shingleton BJ, Bellows AR. et al. Retreatment with argon laser trabeculoplasty. Ophthalmology 1987; 94: 1085-1089
    CrossrefPubMedGoogle Scholar
  • 57 Messner D, Siegel LI, Kass MA. et al. Repeat argon laser trabeculoplasty. Am J Ophthalmol 1987; 103: 113-115
    CrossrefPubMedGoogle Scholar
  • 58 Grayson DK, Camras CB, Podos SM. et al. Long-term reduction of intraocular pressure after repeat argon laser trabeculoplasty. Am J Ophthalmol 1988; 106: 312-321
    CrossrefPubMedGoogle Scholar
  • 59 Feldman RM, Katz LJ, Spaeth GL. et al. Long-term efficacy of repeat argon laser trabeculoplasty. Ophthalmology 1991; 98: 1061-1065
    CrossrefPubMedGoogle Scholar
  • 60 Hong BK, Winer JC, Martone JF. et al. Repeat selective laser trabeculoplasty. J Glaucoma 2009; 18: 180-183
    CrossrefPubMedGoogle Scholar
  • 61 Avery N, Ang GS, Nicholas S. et al. Repeatability of primary selective laser trabeculoplasty in patients with primary open-angle glaucoma. Int Ophthalmol 2013; 33: 501-506
    CrossrefPubMedGoogle Scholar
  • 62 Damji KF, Shah KC, Rock WJ. et al. Selective laser trabeculoplasty v argon laser trabeculoplasty: a prospective randomised clinical trial. Br J Ophthalmol 1999; 83: 718-722
    CrossrefPubMedGoogle Scholar
  • 63 Brooks AM, Gillies WE. Do any factors predict a favourable response to laser trabeculoplasty?. Aust J Ophthalmol 1984; 12: 149-153
    CrossrefPubMedGoogle Scholar
  • 64 Tuulonen A, Airaksinen PJ, Kuulasmaa K. Factors influencing the outcome of laser trabeculoplasty. Am J Ophthalmol 1985; 99: 388-391
    CrossrefPubMedGoogle Scholar
  • 65 AGIS Investigators. The Advanced Glaucoma Intervention Study (AGIS): 11. Risk factors for failure of trabeculectomy and argon laser trabeculoplasty. Am J Ophthalmol 2002; 134: 481-498
    CrossrefPubMedGoogle Scholar
  • 66 Robin AL, Pollack IP. Argon laser trabeculoplasty in secondary forms of open-angle glaucoma. Arch Ophthalmol 1983; 101: 382-384
    CrossrefPubMedGoogle Scholar
  • 67 Lieberman MF, Hoskins HD, Hetherington J. Laser trabeculoplasty and the glaucomas. Ophthalmology 1983; 90: 790-795
    CrossrefPubMedGoogle Scholar
  • 68 Ritch R, Liebmann J, Robin A. et al. Argon laser trabeculoplasty in pigmentary glaucoma. Ophthalmology 1993; 100: 909-913
    CrossrefPubMedGoogle Scholar
  • 69 Harasymowycz PJ, Papamatheakis DG, Latina M. et al. Selective laser trabeculoplasty (SLT) complicated by intraocular pressure elevation in eyes with heavily pigmented trabecular meshworks. Am J Ophthalmol 2005; 139: 1110-1113
    CrossrefPubMedGoogle Scholar
  • 70 Alvarado JA, Iguchi R, Juster R. et al. From the bedside to the bench and back again: predicting and improving the outcomes of SLT glaucoma therapy. Trans Am Ophthalmol Soc 2009; 107: 167-181
    PubMedGoogle Scholar
  • 71 Scherer WJ. Effect of topical prostaglandin analog use on outcome following selective laser trabeculoplasty. J Ocul Pharmacol Ther 2007; 23: 503-512
    CrossrefPubMedGoogle Scholar
  • 72 Singh D, Coote MA, OʼHare F. et al. Topical prostaglandin analogues do not affect selective laser trabeculoplasty outcomes. Eye (Lond) 2009; 23: 2194-2199
    CrossrefPubMedGoogle Scholar
  • 73 Hirn C, Zehnder S, Bauer G. et al. Long-term efficacy of selective laser trabeculoplasty in patients on prostaglandin therapy. Klin Monatsbl Augenheilkd 2014; 231: 351-356
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 74 Blyth CP, Moriarty AP, McHugh JD. Diode laser trabeculoplasty versus argon laser trabeculoplasty in the control of primary open angle glaucoma. Lasers Med Sci 1999; 14: 105-108
    CrossrefPubMedGoogle Scholar
  • 75 Bergeå B, Svedbergh B. Primary argon laser trabeculoplasty vs. pilocarpine. Short-term effects. Acta Ophthalmol 1992; 70: 454-460
    PubMedGoogle Scholar
  • 76 Wechsler DZ, Wechsler IB. Cystoid macular oedema after selective laser trabeculoplasty. Eye (Lond) 2010; 24: 1113
    PubMedGoogle Scholar
  • 77 Rhee DJ, Krad O, Pasquale LR. Hyphema following selective laser trabeculoplasty. Ophthalmic Surg Lasers Imaging 2009; 40: 493-494
    CrossrefPubMedGoogle Scholar
  • 78 Moubayed SP, Hamid M, Choremis J. et al. An unusual finding of corneal edema complicating selective laser trabeculoplasty. Can J Ophthalmol 2009; 44: 337-338
    CrossrefPubMedGoogle Scholar
  • 79 Knickelbein JE, Singh A, Flowers BE. et al. Acute corneal edema with subsequent thinning and hyperopic shift following selective laser trabeculoplasty. J Cataract Refract Surg 2014; 40: 1731-1735
    CrossrefPubMedGoogle Scholar
  • 80 Lee JWY, Chan JCH, Chang RT. et al. Corneal changes after a single session of selective laser trabeculoplasty for open-angle glaucoma. Eye (Lond) 2014; 28: 47-52
    CrossrefPubMedGoogle Scholar
  • 81 Migdal C, Hitchings R. Primary therapy for chronic simple glaucoma the role of argon laser trabeculoplasty. Trans Ophthalmol Soc U K 1985; 104: 62-66
    PubMedGoogle Scholar
  • 82 Elsås T, Johnsen H. Long-term efficacy of primary laser trabeculoplasty. Br J Ophthalmol 1991; 75: 34-37
    CrossrefPubMedGoogle Scholar
  • 83 Tuulonen A, Koponen J, Alanko HI. et al. Laser trabeculoplasty versus medication treatment as primary therapy for glaucoma. Acta Ophthalmol 1989; 67: 275-280
    PubMedGoogle Scholar
  • 84 Rolim de Moura C, Paranhos jr. A, Wormald R. Laser trabeculoplasty for open angle glaucoma. Cochrane Database Syst Rev 2007; (04) CD003919
    PubMedGoogle Scholar
  • 85 Ramulu PY, Parrish RK. Asking the right question in laser trabeculoplasty: “which patient”, not “which laser”?. Surv Ophthalmol 2008; 53: 652-654
    CrossrefPubMedGoogle Scholar
  • 86 Song J, Lee PP, Epstein DL. et al. High failure rate associated with 180 degrees selective laser trabeculoplasty. J Glaucoma 2005; 14: 400-408
    CrossrefPubMedGoogle Scholar