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Tony Realini, Hilda Curtis; Four Year Follow-Up of SLT in Afro-Caribbeans with Open-Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):932.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the 4-year intraocular pressure (IOP)-lowering efficacy of selective laser trabeculoplasty (SLT) used as monotherapy in Afro-Caribbeans
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. Follow-up examinations occurred 1 hour, 1 week, 1 month, 3 months and every three months thereafter through 45 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.
Following washout, IOP in right and left eyes rose from 17.3 (5.0) and 17.5 (4.0) mmHg on medical therapy to 21.4 (3.6) and 21.1 (3.5) mmHg, respectively. At 45 months, 21 patients had been censored or deemed treatment failures, leaving 40 subjects (66%) still deemed treatment successes with at least a 20% IOP reduction from baseline in both eyes and no further IOP interventions after initial SLT. Mean IOP reduction in these 40 subjects at 45 months post-SLT were 8.6 (2.9) mmHg in right eyes and 8.9 (3.0) mmHg in left eyes, representing an average 40% IOP reduction from baseline in both eyes. An additional 6 subjects whose initial SLT failed have undergone repeat SLT, of whom 5 remain controlled on no medications. The proportion of subjects who remain controlled at 45 months on no medications after one or more SLT treatments is 74% (45/61). Four-year data will be collected in January 2015 and presented at the meeting.
Nearly four years after bilateral 360-degree SLT treatment, a majority of Afro-Caribbeans with open-angle glaucoma 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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