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Jeremy Bartley, Chanping Liang, Nick Marrazzo; Factors Affecting the Efficacy of Selective Laser Trabeculoplasty. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):6117.
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Since its introduction in 1974, laser trabeculoplasty has become a common therapy for lowering intraocular pressure in open angle glaucoma patients. Selective laser trabeculopastly (SLT) gained FDA approval in 2001 and is thought to be the safest and most repeatable modality. The purpose of this paper is to analyze factors that may influence the effectiveness of SLT and hopefully aid in the selection of proper patients for the procedure
This was a retrospective chart review of patients who received SLT between November 2011 and December 2012 at the LSU Shreveport Ophthalmology clinic. The study included 236 eyes. Baseline pressures were recorded as the pressure measured at the time the decision to perform SLT was made. Subsequent pressures at follow up glaucoma visits were recorded for 1 year following the procedure. Other factors recorded included age, gender, race, lens status, first or repeat treatment, presence or absence of diabetes, glaucoma medications during the treatment period, presence of absence of laser peripheral iridotomy, and history of glaucoma surgery.
The mean baseline pressure of the group prior to SLT was 19.34958. Averaging each patient’s pressure measurements over the year following SLT revealed a mean pressure of 15.70286. The average percent reduction experienced was 16.627%. Every group analyzed had a statistically significant lower pressure following SLT. Patients on one or no glaucoma medications experienced a greater reduction in pressure than patients on 3 or more medications. There was a trend toward greater response in phakic patients. Diabetic patients had statistically significant higher pressures after 3 months suggesting a shorter duration of effect from treatment.
Though patients on less glaucoma medications experienced a greater reduction in pressure, SLT was found to lower the mean pressure in every group analyzed. This suggests that SLT is a viable option for subsequent pressure lowering in all open angle glaucoma patients. Though some data suggests a possible difference in response, such as more response in phakic patients than pseudophakic, more data will be needed to show that this difference is statistically significant.
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