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L.F. Jindra, A. Gupta; Selective Laser Trabeculoplasty Is Effective as the Primary Treatment of Glaucoma . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5464.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the effectiveness of Selective Laser Trabeculoplasty (SLT) as primary treatment of glaucoma.
A retrospective chart review was performed on 474 out of 1029 eyes in a consecutive case series from patients treated with SLT as primary treatment for glaucoma between January 2002 and January 2005. Intraocular pressure (IOP) for 60 eyes was retrospectively followed for 3 years at 6 month intervals post–SLT. Eyes which required re–treatment with SLT and those which required initiation of topical hypotensive medication were identified.
This group included data from 474 eyes. The study subjects were 57% female with average age of 67.8 years (range: 26.8 – 95.9); mean follow–up was 378 days (range: 4 – 1162). The IOP decreased from a mean of 20.4 mmHg +/– 4.0 (range: 12 – 36) to 13.4 mmHg +/– 3.3 (range: 6 – 32). This represented a 35% mean decrease in IOP or 7.0 mmHg +/– 3.2 (99% CI: 6.7 – 7.5) and was significant with a p–value < 0.0001. For 60 eyes that were followed for 3 years, the mean follow up was 954 days. The average decrease in IOP was 31.2% at 1 year, 33.6% at 2 years, and 34.3% at 3 years (p<0.01). After primary SLT, 15 eyes out of 474 eyes required re–treatment with SLT (5 of these needed meds) – gross laser failure rate was 15/474 (3.2%); net laser failure rate was 10/474 (2.1%). After primary SLT, 18 eyes out of 474 eyes required initiation of topical hypotensive medication (5 of these needed retreat SLT) – gross meds failure rate was 18/474 (3.8%); net meds failure rate was 13/474 (2.7%). After primary SLT, 5 eyes out of 474 eyes (1.1%) required both meds and repeat SLT. These results were significant with a p–value < 0.01.
In patients treated with SLT as primary therapy for glaucoma, mean reduction in IOP was 35%. SLT as a primary treatment was effective in maintaining decreased IOP (average mean reduction of 32.7%) over 3 years. Gross failure of SLT as primary treatment (another intervention needed post SLT– either meds, repeat SLT, or both) was 28/474 (5.9%) and net failure of SLT as primary treatment (meds needed after retreat SLT) was 3/461 (0.7%). In this series, SLT as a primary treatment was effective both as initial and long term therapy in patients with glaucoma.
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