Purchase this article with an account.
Adam L Rothman, Neil A Delwadia, Raju Sarwal, Sandra S Stinnett, Paul P Lee, Leon W Herndon, Pratap Challa; A Comparison of Topical Steroids Versus Non-Steroidal Anti-Inflammatory Drugs after Selective Laser Trabeculoplasty. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6158.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To compare outcomes of glaucoma patients who undergo selective laser trabeculoplasty (SLT) and receive either a topical steroid or non-steroidal anti-inflammatory drug (NSAID) after treatment.
To assess a clinical question as to any differences in SLT success due to post-operative medications, forty-nine subjects were prospectively and randomly assigned to receive either topical fluorometholone or ketorolac following SLT. Intraocular pressure (IOP) and number of glaucoma medications were noted prior to SLT and at 1, 3, 6, 12, 18, 24, 30, and 36 months after SLT. Success 1 was defined as an IOP drop of at least 3 mmHg at each time point while Success 2 was defined as at least a 20% drop in IOP from baseline at each time point. Failure was defined as an increase in the number of medications, repeat SLT, or glaucoma surgery in the same eye. The two groups were compared for baseline characteristics as well as mean change in IOP, mean percent change in IOP, mean change in number of glaucoma medications, Success 1, Success 2, and Failure at the various time points.
Twenty-three subjects received topical steroid while 26 subjects received topical NSAID after SLT. The two groups had similar baseline characteristics of age, sex, race, history of previous laser trabeculoplasty, history of previous surgery, attending physician, laser energy, and number of spots. The baseline mean IOP and mean number of glaucoma medications in the steroid versus NSAID groups were 17.41 ± 5.56 mmHg versus 17.75 ± 4.38 mmHg (p=0.81) and 2.09 ± 1.12 versus 2.23 ± 1.42 (p=0.84), respectively. There was no significant difference in the mean change in IOP, mean percent change in IOP, mean change in number of glaucoma medications, or incidence of Success 1, Success 2, or Failure between the two groups at any time point. At 36 months, the incidence of any Failure for subjects who received steroid versus NSAID was 9/17 (53%) versus 13/21 (62%, p=0.74), respectively, while the incidence of either Success 1 or Success 2 for the remaining subjects was 4/8 (50%) versus 5/9 (56%, p=1.00), respectively.
Comparable reductions in IOP were achieved with the use of either topical steroids or NSAID following SLT. The rate of failure seen in our SLT patients suggests that additional interventions would be required to lower IOP over 36 months of follow-up.
This PDF is available to Subscribers Only