Abstract
Purpose: :
To report surgical outcomes and to investigate preoperative factors associated with the magnitude of intraocular pressure (IOP) reduction following selective laser trabeculoplasty (SLT) in treated open-angle glaucoma (OAG) patients.
Methods: :
A prospective, interventional case series was carried out. Thirty-one uncontrolled OAG glaucoma patients (inadequate IOP control requiring additional treatment) underwent SLT (one single laser session) performed by the same surgeon in a standardized fashion. The same preoperative medical regimen was maintained during follow-up for all patients. Data collected included age, type of OAG, preoperative and postoperative IOP, number of antiglaucoma medications, gonioscopy appearance, surgical complications, and any subsequent related events. Post-treatment assessments were scheduled at week 1 and months 1, 2, and 3. Factors associated with percentage of IOP reduction were investigated using multiple regression analysis.
Results: :
A total of 31 patients (31 eyes) with a mean age of 59.5±13.3 years were enrolled. The mean number of antiglaucoma medications was 2.3±0.7 (range, 1 to 4). Most patients had primary OAG (84%, 26 out of 31). The other 5 patients had pigmentary glaucoma. Mean IOP was reduced from 18.6±2.8 (range, 14 to 24 mm Hg) to 13.5±2.5 mm Hg (range, 10 to 20 mm Hg) at month 3 (P<0.0001). Success rate (defined as IOP≤16mmHg and IOP reduction≥25%) at last follow-up visit was 70.4% and mean percentage of IOP reduction was 26.6±14.1%. Factors significantly associated with magnitude of IOP reduction were baseline IOP (r=0.46, p=0.01) and preoperative number of antiglaucoma medications (r=-0.42, p<0.01). One patient developed sustained IOP rise (≥10% IOP increase in 2 consecutive visits). There were no cases of peripheral anterior synechiae development or any other serious complication.
Conclusions: :
These short-term results confirmed SLT as safe and effective alternative for IOP reduction in treated OAG patients. In addition, better outcomes were found in those with higher preoperative IOP and using fewer medications at baseline.
Keywords: intraocular pressure • laser • trabecular meshwork