Czech and Slovak Ophthalmology 16 Original article Selective Laser Trabeculoplasty – Implication for Medicament Glaucoma Treatment Interruption in Pregnant and Breastfeeding Women Výborný Petr Sičáková Silvia Veselá Flórová Zuzana Sováková Ivana 12 7 2017 2 4

During the period of the last six years (2010-2016), the authors performed Selective Laser Trabeculoplasty (SLT) in 32 women (64 eyes); pregnant women patients with primary open angle glaucoma were referred to the Department of Ophthalmology, First Medical Faculty, Charles University, and Central Military Hospital in Prague, Czech Republic, European Union, to perform this procedure with the goal to interrupt their antiglaucomatic treatment by means of eye drops during the pregnancy and the breastfeeding period. In other 7 cases (14 eyes), they performed the SLT with the goal to terminate the local medicament treatment before planned pregnancy. The procedure was performed on the outpatient basis, during one session, always in both eyes, after one-shot local anesthesia, following their own protocol in the range of 270° of the iridocorneal angle circumferentially, with the parameters 1.0 mJ, 80 shots, 400 μm, using the Tango laser device. All the current local antiglaucomatic treatment was after the performing of the procedure stopped. During the period of pregnancy and breastfeeding, no subjective ophthalmologic problems were neither present, nor objective worsening of visual functions was noticed. According to their own experience, the authors offer the possibility to get over the period of pregnancy and breastfeeding in women patients with primary open angle glaucoma by means of performing the selective laser trabeculoplasty, so without the risk of medicament antiglaucomatic treatment adverse effects.

 glaucoma selective laser trabeculoplasty (SLT) treatment pregnancy breastfeeding References Anne, L.C., Sameh, M., Deborah, K.: Medical therapy in pregnancy. J Glaucoma, 14; 2005: 414–416. Coppens, G., Stalmans, I., Zeyen, T.: Glaucoma medication during pregnancy and nursing. Bull Soc Belge Ophthalmol, 314; 2010: 33–36. Goldberg, I., Sack, J.: Glaucoma in preg - nancy. Dostupné z http://glaucoma.org. au/article-apr2001.htm - 9. 10. 2015 Lustgarten, JS., Podos SM.: Topical timolol and the nursing mother. Arch Ophthalmol, 101; 1983: 1381–1382. Mark, AR.: Management of anesthesia for the pregnant surgical patient. Anesthesiology, 91; 1999: 1159–1163. Morsellli, PL., Boutroy, MJ., Bianchetti, G., et al.: Placental transfer and perinatal pharmacokinetics of betaxolol. Eur J Clin Pharmacol, 38; 1990: 477–483. Olson, DM., Zaragoza DB., Shallow nosti v léčbě glaukomu. Čes a Slov Oftal, 65; 2009 (1): 8–11. Pickering, T.: Treating glaucoma in preg - nancy. Glaucoma Today, March 2009 (March): 18-20. Safran ,MJ., Robin, AL., Pollack, IP.: Argon laser trabeculoplasty in younger patients with primary open-angle glaucoma. Am J Ophthalmol, 97; 2002: 292–295. Sandra, MJ., Mary, M., Sharon, F.: Managament of glaucoma in pregnancy and lactation. Surv Ophthalmol, 45; 2001: 449–454. Sičáková, S., Výborný, P.: Selektivní laserová trabekuloplastika v léčbě glaukomu – výsledky v tříletém sledování. Čes a Slov Oftal, 66; 2010 (5): 204–208. Výborný, P., Sičáková, S.: Selektivní laserová trabekuloplastika – nové mož- Výborný, P., Sičáková, S., Flórová, Z., et al.: The role of selective laser trabeculoplasty (SLT) in discontinuation of local anti-glaucoma therapy in pregnancy and breast-feeding.12th European Glaucoma Society Congress, 19-22 June 2016, Prague. Dostupné z: http://www. eugs.org, P5.36 Výborný, P., Sičáková ,S., Flórová, Z., et al.:The role of selective laser trabeculoplasty (SLT) in discontinuation of local anti-glaucoma therapy in pregnancy and breast-feeding. 120th Meeting of American Academy of Ophthalmology, 15–18 October 2016, Chicago USA. Dostupné z: http://www.aao.org. Wagenvoort, AM., van Vugt, JM., Sobotka, M., et al.: Topical timolol therapy in pregnancy: is it safe for the fetus? Teratology, 58; 1998: 258–262.