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Tony Realini; Three-Year IOP-Lowering Efficacy of Selective Laser Trabeculoplasty in Afro-Caribbeans with Open-Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2014;55(13):821.
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To describe the 3-year intraocular pressure (IOP)-lowering efficacy of selective laser trabeculoplasty (SLT) used as monotherapy in Afro-Caribbeans with open-angle glaucoma.
In this prospective interventional cohort study, 61 St. Lucians with open-angle glaucoma treated with no more than one medication underwent 30-day washout of IOP therapy, baseline IOP determination by two measurements at least 2 hours apart, and bilateral 360-degree SLT. Subjects were seen 1 hour, 1 week, 1 month, 3 months and every three months thereafter through 33 months of follow-up. IOP at every visit was measured using a modified OHTS protocol by a single examiner using a single Perkins tonometer, using the average of 2-3 measurements per time point.
At enrollment, average (SD) IOP in right and left eyes were 17.3 (5.0) and 17.5 (4.0) mmHg on medical therapy; after washout, baseline IOP was 21.4 (3.6) and 21.1 (3.5) mmHg, respectively. At 33 months, 17 patients had been censored or deemed treatment failures, leaving 42 subjects (69%) still deemed treatment successes with no further IOP interventions after initial SLT. Mean IOP reduction in these 42 subjects at 33 months post-SLT were 8.5 (2.6) mmHg in right eyes and 8.5 (3.0) mmHg in left eyes; this represented an average 40% (11%) IOP reduction from baseline in both eyes. All 42 manifested at least a 20% IOP reduction from baseline in both eyes at month 33. In addition to these 42, 5 subjects whose initial SLT failed have undergone repeat SLT, of whom four remain controlled on no medications; thus, 46 subjects (75%) remain controlled on no medications after one or more SLT treatments. Three-year data will be collected in January 2014 and presented at the meeting.
Nearly three years after bilateral 360-degree SLT treatment session, a majority of Afro-Caribbeans enjoy a mean IOP reduction of 40% with no need for medical therapy. SLT could be an important part of the developing world’s burgeoning glaucoma burden.
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