Current review of Excimer laser Trabeculostomy

Georges M. Durr, Marc Töteberg-Harms, Richard Lewis, Antonio Fea, Paola Marolo, Iqbal Ike K. Ahmed

Research output: Contribution to journalReview articlepeer-review

8 Scopus citations

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.

Original languageEnglish (US)
Article number24
JournalEye and Vision
Volume7
Issue number1
DOIs
StatePublished - Dec 2020

Keywords

  • Cataract
  • ELT
  • Excimer laser trabeculostomy
  • Glaucoma
  • Intraocular pressure
  • MIGS
  • Trabeculotomy

ASJC Scopus subject areas

  • Ophthalmology
  • Health Professions (miscellaneous)

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