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A. Gupta, L.F. Jindra; Selective Laser Trabeculoplasty Is Effective as Secondary Therapy in Decreasing Intraocular Pressure and in Reducing Medications in Patients With Glaucoma . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5463.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effectiveness of Selective Laser Trabeculoplasty (SLT) as secondary treatment in decreasing intraocular pressure (IOP) and in reducing the number of medications (meds) in patients with glaucoma.
A retrospective chart review was performed on 433 out of 1029 eyes in a consecutive case series from patients treated with SLT as secondary treatment for glaucoma between January 2002 and January 2005. Two–tailed paired t–tests were used to compare maximum pre– and post–procedure IOP and number of pre– and post–procedure glaucoma meds.
This group included data from 433 eyes. The study subjects were 54% female with average age of 70.2 years (range: 27.5 – 96.7); mean follow–up was 259 days (range: 6 – 1085). The IOP decreased from a mean of 21.9 mmHg +/– 6.4 (range: 7 – 48) to 15.4 mmHg +/– 5.5 (range: 5 – 42). This represented a 30% mean decrease in IOP or 6.5 mmHg +/– 6.2 (99% CI: 5.8 – 7.3). The number of meds decreased from a mean of 2.1 +/– 0.9 (range: 1 – 6) to 0.8 +/– 1.0 (range: 0 – 4). This represented a 63% mean reduction in the number of meds or 1.3 meds +/– 1.1 (99% CI: 1.2 – 1.4). Pre–SLT, 147 of these eyes required one med, 138 of these eyes required two meds, and 148 of these eyes required three or more meds. These data represented one med: 34%, two meds: 32%, and three or more meds: 34%. Post–SLT, 235 of these eyes required no meds, 100 of these eyes required one med, 64 of these eyes required two meds, and 34 of these eyes required three or more meds. These data represented no meds: 54%, one med: 23%, two meds: 15%, and three or more meds: 8%. All results were significant with p–value < 0.0001.
In patients already treated with meds for glaucoma, SLT significantly lowered mean IOP by 30% and reduced mean number of meds by 63%. After SLT and subsequent tapering of meds, gross control of SLT as secondary treatment for glaucoma (one or no meds needed) occurred in 335 out of 433 eyes, which represented a gross control rate of 77%. Net control of SLT as secondary treatment for glaucoma (no meds needed) occurred in 235 out of 433 eyes, which represented a net control rate of 54%. In this series, SLT as a secondary treatment was effective both in reducing IOP and also in decreasing the number of meds in patients with glaucoma.
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