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Ting Ting Liu, Sarah Chao Ying Xu, James C Tsai, Ji Liu; Long-term Outcomes of Laser Trabeculoplasty Prior to Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):6122.
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To evaluate the long-term effect of laser trabeculoplasty on intraocular pressure (IOP) prior to cataract surgery.
A retrospective chart review was performed on all patients who underwent phacoemulsification cataract extraction (CE) with prior argon or selective laser trabeculoplasty (LT) between 2005 and 2013 and a diagnosis of primary open-angle glaucoma or glaucoma suspect (LT-CE Group). A group of age-matched patients who underwent CE without prior LT was used as control (CE Group). Patients were excluded if they had angle closure, complicated cataract surgery, combined cataract and glaucoma surgery, or additional eye surgery during the follow-up period. Independent-samples t-test was performed for statistical analysis.
A total of 18 patients (23 eyes) were identified in the LT-CE Group. The mean IOP reduction from LT was 2.9 ± 2.5 mm Hg (14.7%, p=0.03) at 1 month post laser and the reduction was maintained for at least 6 months; CE further reduced IOP by 2.3 ± 2.4 mm Hg at 6 months post-operatively (14.2%, p=0.007). The CE Group had 18 patients (26 eyes). The mean IOP reduction from CE in the CE Group was not significantly different from CE alone in the LT-CE Group at 6, 12 and 24 months postoperatively. The combined effect of LT and CE produced significantly greater mean IOP reduction compared to that produced by CE alone in both groups at all time points during the follow-up period. The time interval between LT and later CE ranged from 3 weeks to 4 years with a mean of 13.5 ± 15.3 months; no linear correlation was found between mean IOP reduction and time interval from LT to CE (R2=0.0063, p=0.56).
The overall IOP reduction from CE with prior LT was greater than IOP reduction from CE or LT alone. CE was effective in reducing IOP regardless of a history of LT. Patients may benefit from LT prior to CE to attain additive IOP lowering effect.
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