Clinical Study
Eye advance online publication 10 July 2009; doi: 10.1038/eye.2009.172
Excimer laser trabeculotomy vs 180° selective laser trabeculoplasty in primary open-angle glaucoma. A 2-year randomized, controlled trial
S Babighian1, L Caretti1, M Tavolato1, R Cian1 and A Galan1
1Department of Ophthalmology, St Antonio Hospital, Padova, Italy
Correspondence: S Babighian, Department of Ophthalmology, S. Antonio Hospital, Via Facciolati 71, Padova 35100, Italy. Tel:+39 049 8216729, Fax:+39 049 8216448, E-mail: s.babighian@libero.it
Received 16 February 2009; Revised 23 May 2009; Accepted 23 May 2009; Published online 10 July 2009.
Abstract
Purpose
To compare the effectiveness and safety of excimer laser trabeculotomy (ELT) ab interno vs selective laser trabeculoplasty (SLT) over 24 months of follow-up in patients with primary open-angle glaucoma (POAG) refractory to medical therapy.
Patients and methods
This prospective, randomized study included 30 consecutive eyes assigned randomly to either ELT or SLT group. ELT was carried out using a XeCl Excimer Laser with an emission wavelength of 308 nm. Eight spots were equally distributed at a distance of 500 
m from one another over the anterior trabeculum. The SLT patients were treated with a frequency-doubled q-switched neodymium : yytrium–aluminum–garnet laser (wavelength 532 nm). Approximately 50 adjacent, but not overlapping, laser spots were distributed over 180° of the trabecular meshwork, using an energy level ranging from 0.7 to 1.0 mJ per pulse. The main outcome measure was intraocular pressure (IOP) lowering after ELT and SLT. Success was defined as 
20% reduction in IOP without further glaucoma intervention.
Results
At 24 months, complete success rates were 53.3% for the ELT group and 40% for the SLT group (P=0.35, Fisher's exact test); qualified success rates were 33.3% for the ELT and 26.6% for the SLT group (P=0.5, Fisher's exact test).Mean IOP decreased from 25.0
1.9 to 17.62.2 mmHg (-29.6%; P<0.0001) in the ELT group and from 23.90.9 to 19.11.8 mmHg (-21%;P<0.0001) in the SLT group.
Conclusions
Both ELT and SLT proved to be effective techniques in the treatment of POAG refractory to medical therapy.
Keywords:
glaucoma, selective laser trabeculoplasty, excimer laser trabeculotomy
