Page 194 - HA Convention 2015

Service Priorities and Programmes Free Papers

SPP8.3 Young Hospital Authority Investigators Presentations 14:30 Room 221

MicroPulse Laser Trabeculoplasty for the Treatment of Primary Open Angle Glaucoma
Lee JWY, Yick DWF, Yuen CYF
Department of Ophthalmology, Caritas Medical Centre, Hong Kong

Introduction

Primary open angle closure glaucoma (POAG) is a chronic eye disease characterised by irreversible optic nerve damage due
to elevated intraocular pressure (IOP). IOP-lowering medications are first-line therapy before invasive surgeries. Medications
have various side effects including eye irritations, allergies, and poor adherence. Glaucoma surgery complications include
bleeding, infection, reduced vision, and even blindness. Micro-pulse laser trabeculoplasty (MLT) is the newest generation of
non-invasive eye laser that lowers IOP with less inflammation than its predecessors and fewer complications than medication
or surgery. MLT is an outpatient procedure that is without scar, external wound, or infection and is repeatable.

Objectives
To investigate the safety and efficacy of adjuvant MLT in treating Hong Kong Chinese suffering from POAG.

Tuesday, 19 May Methodology

This was a prospective case-controlled study. Consecutive, POAG subjects were randomised to receive MLT in one eye
while the fellow (control) eye continued medication use. Subjects were excluded if they had previous laser trabeculoplasty,
one functional eye, or corneal pathologies. After one month, medications in both eyes were titrated to achieve either an IOP
reduction of 25% from first presentation or an IOP<18mmHg, whichever was lower. The following were compared before and
after MLT using the Repeated Measures Analysis of Variance (ANOVA) with Bonferroni’s Multiple Comparison Test: IOP and
number of medications pre-MLT, day one, one week, and one, three, and five months post-MLT. The above parameters were
also compared between both eyes using T-test. P≤0.05 was statistically significant.

Results

In 40 Chinese subjects, the mean age was 63.6±12.8 years. Prior to MLT, both eyes had statistically similar IOP and number
of medications (P≥0.1). At five months, MLT treated eyes had 18.0% IOP reduction in addition to 21.4% medication reduction
compared to the pre-treatment (both P<0.0001). MLT treated eyes had 6.1% lower IOP and 13.6% fewer medications
compared to the fellow eye (P≥0.1). None of the MLT treated eyes had any long-term side effects and none required
hospitalisation; only 10.0% had a mild self-limiting anterior chamber inflammation at one-week post-laser. To the best of our
knowledge, this is the first and largest clinical application of MLT in Hong Kong and in Chinese patients worldwide. MLT is
an innovative technology that delivered an effective clinical enhancement via an 18% IOP reduction plus a 21% reduction in
medication expenditure with zero long-term complications and hospitalisation. MLT has immense potential as an alternative
to anti-glaucoma medication and surgery in an era where safe, professional, and patient-centred cares are top priorities.

HOSPITAL AUTHORITY CONVENTION 2015

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