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Tatiana C. Franco, Natalie C. Cheung, Ann Ostrovsky, Alexander Barash, Craig H. Marcus, Arnold S. Prywes, Robert F. Rothman, John Danias, Janet B. Serle; Effect of Repeat Selective Laser Trabeculoplasty in Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2621.
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To assess efficacy of repeat selective laser trabeculoplasty (SLT) in glaucoma patients without prior glaucoma laser treatment or surgery.
A retrospective chart review of 30 eyes of 30 patients, ≥ 18 years of age, with open-angle glaucoma (primary open-angle, pseudoexfoliation or pigmentary), no prior history of glaucoma laser or surgery, at least 2 SLT treatments and ≥ 3 months of follow-up after each SLT. 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 each SLT treatment or until one of the endpoints were met: additional SLT, seton, trabeculectomy, combined procedure, or cataract surgery..
Thirty patients received one and then a second SLT and 14 patients received three SLT treatments. Following first SLT, IOP reductions were observed for at least 15 months (P<0.05 using paired t tests). Of the 30 patients that underwent first SLT, 16 patients (53%) underwent repeat SLT within 15 months and 14 patients (47%) underwent repeat SLT > 15 months after SLT 1. Following second SLT, IOP reductions were observed only at 1 and 12 months (P<0.05 using paired t tests). Of the 30 patients that underwent a second SLT, 7 patients (23%) underwent a third SLT, 3 patients (10%) underwent glaucoma surgery and 1 patient underwent cataract extraction (1%) within 15 months.
One SLT treatment in glaucoma patients without prior history of glaucoma laser or surgery on multiple medications appears to be beneficial in lowering IOP for at least 15 months. Repeat SLT treatments appear to be of limited efficacy in this patient population.
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