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Collin Hair, Scott M Walsman; Resident Experience with Micropulse Laser Trabeculoplasty versus Selective Laser Trabeculoplasty: A 1-Month Comparison. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6483.
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© ARVO (1962-2015); The Authors (2016-present)
Little is known about the effectiveness of micropulse laser trabeculoplasty (MLT) and how it compares clinically to selective laser trabeculoplasty (SLT). We preformed a retrospective chart review of patients with primary open angle glaucoma comparing intraocular pressure (IOP) reduction between MLT and SLT.
A total of 10 eyes treated with MLT and 26 eyes treated with SLT were reviewed from a single resident clinic from November 2012 to September 2015. Laser settings for MLT were 532 nm, 300 ms, 1000 mW, 15% duty cycle and for SLT power settings ranged between 1.0 and 1.2 mJ, both 360 degree treatment area. A paired t test was used to compare post treatment IOP at various time points with a constant baseline IOP. A Mann-Whitney U test was used to directly compare MLT to SLT. Age, vision, cup-to-disc ratio, mean deviation of automated visual field, lens status, and the number of glaucoma drops were recorded.
MLT failed to significantly reduce IOP at any time point. At 1 month, the average decrease from the baseline IOP was only 0.23mmHg or a 0.62% reduction (N=9, p=0.82). At 3 and 6 months, there was an average reduction by only 1mmHg (6.53%) and 1.3mmHg (8.37%), respectively [N=3 both]. There was too little data at these time points to run a statistical analysis. In contrast, SLT significantly reduced IOP from baseline at all time points from 1 week to 12 months. At 1 month, SLT provided an average 3.67mmHg reduction from baseline (19.7%, N=19, p=0.000125). At 3 and 6 months, the average reduction was 3.45mmHg (17.12%, N=10, p=0.006) and 3.76mmHg (20%, N=16, p=0.000015), respectively. In direct comparison, at 1 month SLT was found to lower IOP significantly more than MLT, 3.67mmHg vs 0.23mmHg (p=0.00988).There was no statistically significant difference between average demographics of the MLT and SLT groups including age (62.4 vs. 63), number of glaucoma drops (2.2 vs. 1.7), cup-to-disc ratio (0.82 vs. 0.77), mean deviation (-7.0 dB vs. -9.52 dB), lens status (70% phakic vs. 77% phakic), or baseline IOP (18.1 vs. 18.2).
MLT failed to significantly lower IOP at 1 month for patients with primary open angle glaucoma. In contrast, SLT provided a significant decrease at all time points sustained to 12 months. More data is needed to see if MLT significantly reduces IOP at later time points.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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