الفهرس 
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Abstract
Selective laser trabeculoplasty is a safe and effective means of lowering IOP. Its development has renewed the interest in laser trabeculoplasty. SLT was developed as an alternative to ALT in the treatment of open angle glaucoma because of its selective photothermolysis properties. SLT selectively targets only the pigmented TM cells and avoids any collateral damage to the surrounding cells and structures. Thus, avoiding permanent scarring of the TM as occurs with ALT. Hopefully, this translates clinically into a procedure that avoids the disadvantages of ALT including immediate postoperative IOP elevation, decreased long term efficacy, and interference with any needed post-laser filtering operation. Also, SLT helps as an alternative or adjunctive treatment for glaucoma patients already on medical treatment, who are not well controlled, non-compliant or intolerant of medical treatment. Thus, SLT may help in overcoming the trouble of non compliance, which is an important cause of visual loss in patients with glaucoma, either by replacing or simplifying the regimen of medical treatment. In this study SLT 360o treatment was performed in 2 groups of patients with POAG , the first group included patients with newly diagnosed POAG (primary treatment group), and the second group included patients diagnosed with POAG currently on medical treatment , either intolerant of medical treatment or not well controlled to the target level (secondary treatment group). After SLT, patients were followed up for at least 6 months for reduction of IOP, and the need of adjuvant medical treatment, and the results were compared to the control group which includes patients with POAG controlled on prostaglandins analogues eye drops. Results of this study were as follow: The first group: This group included 20 eyes in 10 patients with newly diagnosed POAG (Primary treatment group) .In this group: • The IOP was decreased from 25.5 ± 1.24 mmHg before treatment to 17.95 ± 1.23 mmHg in the last follow up visit. • The average absolute reduction of IOP was 7.41± 0.839 mmHg. • The average percent reduction of IOP was 29.8%. • 6 eyes in 3 patients (30%) showed increase in IOP around the 3rd month, with the need of one topical glaucoma medication (Beta-blocker) to control the IOP. The second group: This group included 34 eyes in 17 patients diagnosed with POAG currently on medical treatment, either intolerant of medical treatment or not well controlled to the target level (secondary treatment group) In this group: • The IOP was decreased from 21.32 ± 2.23 mmHg before treatment to 17.38 ± 1.55 mmHg in the last follow up visit. • The average absolute reduction of IOP was 3.94 ± 0.7 mmHg. • The average percent reduction of IOP in this group was 18.01%. • From this secondary treatment group 12 eyes in 6 patients (35%) showed increase in IOP around the 3rd month, with the need of one topical glaucoma medication to control the IOP. • The mean number of medications was reduced from 1.4 ± 0.7 to 0.35 ± 0.1. In both the first and second groups : • The reduction of IOP was greatest 24 hours after SLT. • There was no serious immediate complications occurred after SLT, and any mild complications encountered was resolved maximum within 4 days under cover of topical steroids. The control group: • The IOP was decreased from 24.85± 0.75mmHg before medical treatment to 17.10 ± 0.79 mmHg in the last follow up visit. • The average absolute reduction of IOP was 7.3 ± 1.218 mmHg. • The average percent reduction of IOP in this group was 29.31%.