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Ernesto Golez, Mark Latina; Longitudinal evaluation of selective laser trabeculoplasty repeatability in eyes with pseudoexfoliation glaucoma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1857. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the repeatability of SLT in patients with pseudoexfoliation glaucoma
Retrospective, chart review of pseudoexfoliation glaucoma (PXFG) patients who underwent initial and/or repeat SLT between January 2001 and March 2012 was performed. Patients with history of prior incisional or laser procedure in the eye were excluded. IOPs, percent IOP reduction and number of glaucoma medications were compared before and after the first and the subsequent laser treatments. The number of laser spots per SLT, and duration of SLT efficacy were documented. If no subsequent laser treatment was performed, it was noted whether the eye had been controlled medically or undergone surgery.
A total of 79 eyes of 56 patients were included; 24 were males and 32 were females. Of the 79 eyes which underwent SLT #1, 21 (27%) underwent SLT #2 and 5 (6.3%) underwent a SLT #3. Of the remaining eyes after SLT #1, 54% (43/79) had their IOP controlled without additional SLT while 19% (15/79) underwent surgery. Of the remaining eyes after SLT #2, 52% (11/21) had their IOP controlled without additional SLT while 21% (5/21) underwent surgery. After SLT #3, 40% (2/5) of eyes had their IOP controlled without further treatment while 60% (3/5) underwent surgery. The mean laser spots performed was not statistically different for every laser session (SLT #1 63.6±12, SLT #2 60.2±10, and SLT #3 53.8±8). The duration between SLT treatments was a mean of 29±24 months between SLT #1 and #2 and mean of 17±11 months between SLT #2 and #3. Percent IOP reduction after SLT #1 was 39%±18, after SLT #2 was 33%±14 and after SLT #3 was 36%±19. In all 3 procedures, the percent reduction was statistically significant. There was no significant change in the mean number of medications pre and post SLT #1 (from 1.91 to 2.05, p=0.12) and SLT #3 (from 2.00 to 2.20, p=0.37); however the mean number of medications significantly increased pre and post SLT #2 (from 2.19 to 2.67, p<0.05).
SLT was effective in reducing IOP in both initial and repeat treatments in PXFG eyes. The percentage of eyes maintaining IOP control without additional SLT (~50%) and those requiring surgery (~20%) were similar after SLT #1 and #2. Although a small group of patients, 60% of eyes required surgery after SLT #3 .
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