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Start Over Author "Kontić Marko" Topic selective laser trabeculoplasty
3 results on '"Kontić Marko"'

1. Selective laser trabeculoplasty as adjunctive treatment in pseudoexfoliative glaucoma patients

Author

Kontić Marko, Todorović Dušan, Zečević Rada, and Šarenac-Vulović Tatjana

Subjects
selective laser trabeculoplasty, pseudoexfoliative glaucoma, intraocular pressure, Medicine
Abstract

Introduction/Objective. Pseudoexfoliation syndrome is characterized by abnormal production and accumulation of fibrillar, white-gray, “dandruff-like” material in almost all ocular structures. The aim of this study was to examine effect of selective laser trabeculoplasty in pseudoexfoliation glaucoma patients. Methods. Thirty-two patients (47 eyes) with medically uncontrolled pseudoexfoliation glaucoma were enrolled. All the patients could not reach target intraocular pressure with maximal tolerated medical therapy before treatment. Selective laser trabeculoplasty was performed with about 100 non-overlapping spots. Intraocular pressure was measured one hour, seven days, four weeks, three, six, twelve, eighteen, and twenty-four months after the procedure. Results. The mean base intraocular pressure was 23.45 mmHg (SD = 3.07). Statistically significant reduction of mean intraocular pressure was observed at all follow-ups except one hour after treatment. Mean intraocular pressure after 24 months was 18.39 mmHg (SD = 1.82). Success, defined as intraocular pressure reduction from base intraocular pressure by more than 20% after 24 months, was achieved in 27 eyes (57.45%). We did not find any influence of sex and age on selective laser trabeculoplasty effects in pseudoexfoliative glaucoma patients. Baseline intraocular pressure is proved to be a reliable predictor of intraocular pressure-lowering effect, as there was a strong correlation between baseline intraocular pressure and the percentage of reduction of intraocular pressure after 24 months (r = 0.71, p < 0.01). Conclusion. Selective laser trabeculoplasty is a safe and effective method for the reduction of intraocular pressure in pseudoexfoliation glaucoma patients and should be used more often in this challenging form of glaucoma. Baseline intraocular pressure seems to be a reliable predictor of success.

Published
2022
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2. Hypotensive effect of selective laser trabeculoplasty in patients with medically uncontrolled primary open-angle glaucoma

Author

Kontić Marko, Ristić Dragana, and Vukosavljević Miroslav

Subjects
laser, primary open-angle glaucoma, selective laser trabeculoplasty, treatment, Medicine
Abstract

Introduction. Glaucoma is a chronic, progressive disease of the optic nerve which if left untreated can lead to blindness at end stages. A decrease of intraocular pressure (IOP) has proven to slow down the progression of the disease. IOP decrease can be achieved by medical, laser and surgical treatment. Objective. The aim of this study was to evaluate the response of patients with medically uncontrolled primary open angle glaucoma to selective laser trabeculoplasty (SLT). Methods. The study involved baseline characteristics recorded for each of 35 patients (48 eyes) in whom, despite being under full medication we could not achieve a satisfactory IOP. Patients, who had pressure above 25 mmHg under the maximal medication therapy, were not included into the study and were referred for surgical treatment. IOP was measured on admission, 1 hour, 7 days, 1, 3, 6 and 12 months after SLT. We considered satisfactory surgical result if IOP was decreased more than 20% of the initial value. Also, we investigated the influence of baseline IOP on SLT outcome after 12 months. Patient inclusion criteria were inability to reach target IOP with maximal medical therapy. Exclusion criteria were congenital glaucoma, any type of angle closure glaucoma, advanced-stage glaucoma, eyes with previous laser or surgical glaucoma applications and patients with baseline IOP >25 while fully medicated. Patients who could not be followed for at least 12 months were also excluded. Results. The mean age of our patients was 73±12 years. The mean baseline IOP was 20.48 mmHg (SD=1.91), and the mean change in IOP from baseline of the treated eye after one year was 4.47 mmHg (SD=2.12). In eyes with a higher baseline IOP the reduction of pressure at the end of the study was significantly higher. Satisfactory effect of IOP reduction after one year was achieved in 64.58% of eyes. The IOP reduction did not show to be dependent as regarding age and gender. Conclusion. SLT effectively lowers IOP in patients with primary open-angle glaucoma, and the intervention is not followed by significant complications. Our results confirm that the IOP reduction is more significant if the initial value is higher. Our first reliable results of IOP reduction were confirmed one month after the procedure so that the procedure should not be repeated before one month has elapsed. The study is limited by a small number of eyes, which is insufficient to make a complete case analysis.

Published
2014
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3. Uticaj selektivne laser trabekuloplastike na visinu intraokularnog pritiska kod pacijenata sa glaukomom

Author

Kontić, Marko, Janićijević Petrović, Mirjana, Vukosavljević, Miroslav, Jovanović, Svetlana, and Srećković, Sunčica

Subjects
inicijalna terapija, Selective laser trabeculoplasty, Glaukom, primarni glaukom otvorenog ugla, SLT, selektivna laser trabekuloplastika, glaucoma pigmetary, očni pritisak, dodatna terapija, kapsularni glaukom, pigmentn glaukom, Glaucoma pseudoexfoliativum, primary open angle glaucoma
Abstract

Redukcija intraokularnog pritiska (IOP) predstavlja još uvek jedini način lečenja glaukoma. Selektivna laser trabekuloplastika (SLT) je nova metoda za lasersko snižavanje IOP-a. U stranoj stručnoj literaturi se navodi da se posle primene SLT-a sniženje intraokularnog pritiska kretalo u širokom rasponu od 2,1 do 10,6mmHg odnosno od 12,1 do 39,9% u odnosu na početnu vrednost. Takođe u literaturi ne postoje pouzdani podaci o poređenju efekata SLT-a kod pacijenata sa različitim oblicima glaukoma, odnosno o efektu kada se metoda koristi kao inicijalna ili kao dodatna terapija. U studiju smo uključili pacijente sa primarnim glaukomom otvorenog ugla, sa pseudoeksfolijativnim glaukomom kao i sa pigmentnim glaukomom kod kojih je primenjen SLT kao inicijalna i kao dodatna metoda u lečenju. U studiju je bilo uključeno 126 pacijenata (183 oka). Kontrole su vršene pre intervencije, zatim 1 sat, 7 dana, 1, 3, 6 i 12 meseci posle intervencije. Procenat uspešnosti SLT-a, za šta smo smatrali redukciju IOP-a od bar 20% 12 meseci posle intervencije, kretao se od 58% u grupi pacijenata sa pseudoeksfolijativnim glaukomom kod kojih je SLT korišćen kao dodatna do 77% kod pacijenata sa primarnim glaukomom otvorenog ugla kod kojih je SLT korišćen kao inicijalna metoda u lečenju. Prosečan procenat redukcije IOP-a po grupama u odnosu na baznu vrednost, posle 12 meseci se kretao od 23,2% do 27,8% i nije postojala statistički značajna razlika između različitih vrsta glaukoma. Procenat redukcije je bio bolji kod pacijenata kod kojih je SLT korišćen kao inicijalna metoda, ali ta razlika nije dostigla statističku značajnost. Najčešće komplikacije sa kojima smo se susretali su bile postoperativni skok IOP-a do koga je dolazilo u 10 do 18% slučajeva kao i ćelijska reakcija u prednjoj komori koja se pojavljivala u 14 do 36% slučajeva. Visina baznog intraokularnog pritiska je bila u korelaciji sa visinom procenta redukcije IOP-a. Selektivna laser trabekuloplastika je efikasna i sigurna metoda za snižavanje intraokularnog pritiska kod pacijenata sa glaukomom. Ovo istraživanje je pokazalo da se SLT, osim kao dodatna, može koristiti kao inicijalna terapija u lečenju različitih vrsta glaukoma i da inicijalna medikamentna terapija glaukoma može da se zameni selektivnom laser trabekuloplastikom, posebno kod pacijenata koji su pokazali intoleranciju na lokalnu medikamentnu terapiju kao i lošu komplijansu, odnosno da se kod nedovoljnog efekta medikamentne terapije lečnje dopuni SLT-om i da se na taj način odloži ili izbegne klasična hirurška intervencija. Intraocular pressure (IOP) reduction is the only way of treating glaucoma currently. Selective laser trabeculoplasty (SLT) is one of new laser methods for treatment of open angle glaucoma. In scientific literature we found that IOP lowering effect ranged from 2.1 to 10.6mmHg or from 12.1 to 39.9% compared to baseline after SLT. Also in the literature there are no reliable data on the effects of SLT compared in patients with various forms of glaucoma, or the effect when the method is used as initial or as additional therapy. The aim of this study was to investigate the effects of initial or adjuvant SLT on IOP in patients with primary open-angle glaucoma, pseudoexfoliative glaucoma and pigmentary glaucoma. One hundred and twenty six patients (183 eyes) were enrolled in the study. Outcomes were measured at baseline and at 1 hour, 7 days, 1, 3, 6 and 12 months after the intervention. The success rate of SLT (reduction of IOP of at least 20% from baseline) 12 months after the intervention ranged from 58% in the group of patients with pseudoexfoliative glaucoma in which the SLT is used as an adjuvant treatment, to 77% in patients with primary open angle glaucoma in which SLT was used as initial treatment. The mean 151 percentage of IOP reduction compared to the baseline value after 12 months ranged from 23.2% to 27.8% and there was no statistically significant difference between the different types of glaucoma. The percentage of IOP reduction was better when SLT was used as the initial treatment, but the difference did not reach statistical significance. The most common complications were transient postoperative IOP rise that occurred in 10 to 18% of cases, as well as the cell reaction in the anterior chamber, which appeared in the 14 to 36% of cases. Base intraocular pressure value was in correlation with the percent of reduction of IOP. The selective laser trabeculoplasty is an effective and safe method for lowering intraocular pressure in glaucoma patients. This research has shown that the SLT, except as adjuvant, may also be used as initial treatment for different types of glaucoma and initial medical treatment for glaucoma could be replaced by selective laser trabeculoplasty, especially in patients who show intolerance to local medical therapy and low compliance. Also many patients which cannot reach target IOP with medical therapy respond very well to adjuvant SLT and are able to postpone or avoid classic surgical intervention.

Published
2016

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