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Natalie C. Cheung, Ann Ostrovsky, Tatiana Franco, Alexander Barash, Craig H. Marcus, Arnold S. Prywes, Robert F. Rothman, John Danias, Janet B. Serle; Effect of Repeat Selective Laser Trabeculoplasty After Prior Argon Laser Trabeculoplasty in Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2620.
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To assess efficacy of repeat selective laser trabeculoplasty (SLT) after prior argon laser trabeculoplasty (ALT) in glaucoma patients.
A retrospective chart review of 40 eyes of 40 patients, ≥ 18 years of age, with open-angle glaucoma (primary open-angle, pseudoexfoliation or pigmentary) and prior ALT followed by at least one SLT and ≥ 3 months of follow-up. Intraocular pressure (IOP) and number of glaucoma medications were recorded at baseline (within the 4 weeks preceding each SLT) and at 1, 3, 6, 9, 12, 15 months after SLT treatment or until one of the following endpoints were met: the patient underwent glaucoma surgery (valve, trabeculectomy, or combined procedure), received additional SLT, or had cataract surgery.
Forty patients received 1 SLT treatment and 16 patients received 2 SLT treatments. Following first SLT, IOP reductions were observed for at least 12 months (p<0.05 using paired t tests). Of the 40 patients that underwent initial SLT, 9 patients (23%) had repeat SLT and 8 patients (20%) had glaucoma surgery within 15 months. In addition, 7 patients (18%) had repeat SLT > 15 months after initial SLT. Of the 16 patients that underwent second SLT, IOP reductions were only observed at 3 months (p<0.05 using paired t tests), 2 patients (13%) received further SLT, and 8 patients (50%) had glaucoma surgery, within 15 months. There were no significant changes in number of medications following SLT 1 or SLT 2.
One SLT treatment after prior ALT appears to be beneficial in lowering IOP for at least 12 months in patients on multiple medications. Repeat SLT treatments after one SLT in patients with prior ALT appear to be of limited efficacy in this patient population.
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