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Mamta Shah, Babak Eliassi-Rad; Predictive Factors of Selective Laser Trabeculoplasty (SLT) Outcome in Open-Angle Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5964.
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To investigate both demographic and other preoperative factors associated with selective laser trabeculoplasty (SLT) outcome in open-angle glaucoma (OAG) patients.
A retrospective chart review of 106 OAG patients with inadequate intraocular pressure (IOP) control who underwent SLT by the same surgeon (B.E.R.) from 2005 to 2010 at Boston Medical Center. We analyzed the effects of number of medications and central corneal thickness (CCT) pre-SLT, age at SLT, baseline IOP, and immediate IOP spike on SLT outcome. IOP and number of medications were recorded before SLT and up to 2 years after SLT.
A total of 106 patients (138 eyes) were studied. Characteristics of the study sample are summarized in Table 1. For patients on 0-1 anti-glaucoma medications, mean IOP change was 2.3 mmHg (p=0.07) at 1 year and 4.2mmHg (p=0.0009) at 2 years. For patients on 2-3 medications, mean IOP change was 3.6mmHg (p=0.001) at 1 year and 3.0mmHg (p=0.03) at 2 years. For CCT >540µm, mean IOP change was 3.1mmHg (p<0.02) at 1 year and 1.4mmHg (p=0.38) at 2 years. For patients age <65, mean IOP change was 1.9mmHg (p=0.03) at 1 year and 4.0mmHg (p<0.005) at 2 years. For baseline IOP at SLT of 16-21mmHg, mean IOP change was 1.9mmHg (p=0.008) at 1 year and 3.1mmHg (p<0.0004) at 2 years. For IOP spike ≥5mmHg immediately after SLT, mean IOP change was 1.7mmHg (p=0.32) at 1 year and 1.3mmHg (p=0.72) at 2 years.
Factors associated with significant IOP reduction at 1 and 2 years post-SLT were: 0-3 pre-operative glaucoma medications, age <65, and baseline IOP of 16-21mmHg. CCT >540µm was significantly associated with IOP reduction at 1 year post-SLT but not at 2 years. IOP spike ≥5mmHg immediately after SLT was associated with a negative outcome at 1 and 2 years.
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