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T. Realini, J. Charlton, M. Hettlinger; The Role of Prednisolone Acetate in the Postoperative Period Following Selective Laser Trabeculoplasty. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5674.
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It is theorized that postoperative inflammation following selective laser trabeculoplasty (SLT) may play a role in the mechanism of action by which SLT lowers intraocular pressure (IOP). This study was designed to clarify the role of topical prednisolone acetate in the postoperative period following SLT.
25 open-angle glaucoma patients undergoing bilateral SLT were prospectively enrolled and randomized to receive prednisolone acetate QID for one week in one eye and no treatment in the fellow eye. Follow-up evaluations at 1 week, one month and three months were performed by an investigator masked to the treatment randomization; IOP and anterior chamber (AC) inflammation were recorded at pre-treatment baseline and at each postoperative visit.
Baseline IOP was 18.4 mmHg in both the treatment and observation groups. At one week, IOP dropped by 2.0 and 2.6 mmHg in the treatment and observation groups, respectively (p=0.60). At one month, IOP dropped by 1.5 and 2.3 mmHg (p=0.56), and by three months, IOP dropped by 3.7 and 3.5 mmHg, respectively (p=0.86). At one week, four treated and seven observed eyes had trace cells in the AC; at one month, one treated and one observed eye had trace cell; and by three months, no eyes had any AC inflammation.
Suppressing inflammation after SLT does not appear to diminish SLT’s effect on IOP. However, suppression of inflammation does not appear to be necessary, as the inflammation is mild and prednisolone acetate QID for 1 week only reduced the incidence of AC inflammation by 43% (3/7).
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