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J D. Nussdorf, A C. Janot, D. W. Hanson, P. J. DeMarco; Baseline Intraocular Pressure Strongly Predicts Response to Selective Laser Trabeculoplasty for Open Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5969.
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To evaluate patient factors that may influence the response to selective laser trabeculoplasty (SLT) in patients with poorly controlled open angle glaucoma (OAG) while ocular drug therapy was held constant over a 1 year period.
A retrospective chart review was performed to evaluate patient factors which may impact the intraocular pressure (IOP) lowering response of SLT in consecutively treated patients with OAG while receiving fixed ocular drug therapy. Each patient was treated with single session SLT 3600 performed by one of two glaucoma specialists to augment IOP control in patients not achieving target IOP despite medical therapy. The first eye receiving SLT was included for analysis. We defined baseline IOP as the average IOP of 3 consecutive visits while on fixed ocular drug therapy prior to SLT treatment. A total of 73 eyes met inclusion criteria and were followed for up to 1 year with a minimum of 3 post-treatment IOP measurements. Patient factors for our analysis include age, phakic status, topical prostaglandin (PG) use and baseline IOP.
We studied 73 patients with a mean age of 71.74 years, 16 eyes were phakic and 47 pseudophakic, taking an average of 2.4 glaucoma medications with 46 using prostaglandins. The average pre-treatment IOP was 18.5 mm Hg with a range from 11.8 to 32.8 mm Hg and the average post-treatment IOP was 15.3 mm Hg. A repeated measures analysis of variance was used to assess the effects of patient variables on post-SLT IOP response. The analysis showed that SLT produced a significant decrease in IOP of 3.2 mm Hg. We found that neither age, phakic status nor PG use significantly impacted the IOP response to SLT. However, regression analysis demonstrated that baseline IOP had a significant effect such that higher baseline IOP was associated with a greater IOP lowering response to SLT.
The patient factors of age, phakic status and PG use did not significantly impact the IOP lowering effect of SLT. However, baseline IOP demonstrated a positive influence on IOP lowering following SLT treatment. In this study, patients with higher baseline IOPs demonstrated a greater IOP lower response to SLT treatment.
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