Stellenwert der selektiven Lasertrabekuloplastik (SLT)

Zusammenfassung

Hintergrund Die selektive Lasertrabekuloplastik (SLT) hat sich in den letzten Jahren zu einer sehr erfolgreichen Behandlungsform des Glaukoms entwickelt.

Material und Methoden Aktuelle Literaturrecherche in PubMed. Eigene klinische Erfahrungen flossen in die Bewertung von Zusammenhängen ein.

Ergebnisse Die SLT kann mit vergleichbarer Effektivität wie eine Argonlasertrabekuloplastik (ALT) oder eine medikamentöse Ersttherapie bei allen häufigen Formen des Offenwinkelglaukoms und der okulären Hypertension eingesetzt werden. Im Vergleich zur ALT zeigt die SLT Vorteile: Es wird wesentlich weniger Energie benötigt und die SLT kann wiederholt werden. Die SLT hat auch Anwendung in einigen selteneren Indikationsbereichen gefunden. Sie beeinflusst andere Formen der Glaukombehandlung nicht negativ. Die Risiken sind gering und beinhalten Druckspitzen und sehr selten Hornhautveränderungen (Endothelzellversagen, Hornhauttrübung und -vernarbung) oder ein zystoides Makulaödem. Aufgrund ihres Potenzials als Ersttherapie wird die SLT auch aktuell intensiv beforscht.

Schlussfolgerung Die SLT ist eine risikoarme Behandlungsmethode des Glaukoms mit sehr breitem Indikationsbereich. Aufgrund der Vorteile der SLT ist eine weitere Verbreitung als Ersttherapie denkbar. Die SLT ist deshalb Gegenstand der aktuellen Forschung.

Abstract

Purpose Worldwide, in recent years, selective laser trabeculoplasty (SLT) has developed into a very successful therapy for glaucoma.

Material and Methods The article provides a review of the literature from PubMed and clinical experience.

Results SLT is equally efficacious to argon laser trabeculoplasty (ALT) and to a first-line glaucoma medication. SLT can be used in most common forms of open-angle glaucoma and ocular hypertension. In contrast to ALT, SLT is repeatable and requires much less energy. SLT has been reported to be also successful in some rare forms of ocular hypertension/glaucoma. There is no negative influence of SLT to other forms of glaucoma treatment. Complications are rare and include intraocular pressure spikes, corneal scarring or corneal decompensation due to endothelial cell damage and cystoid macular edema. The potential of SLT as a first-line treatment of glaucoma is now under investigation.

Conclusion SLT is a low-risk procedure to treat glaucoma in a broad range of indications. Advantages of SLT include the potential to use SLT more and more as a primary treatment procedure. Therefore, SLT is now under intensive investigation worldwide.

Schlüsselwörter

SLT - selektive Lasertrabekuloplastik - Glaukom - okuläre Hypertension - Therapie

Key words

SLT - selective laser trabeculoplasty - glaucoma - ocular hypertension - therapy

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