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S. Jea, L. R. Pasquale, C. L. Grosskreutz, D. J. Rhee; Predictors of Success of Selective Laser Trabeculoplasty. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4420.
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To determine the predictive value of selective laser trabeculoplasty (SLT) results in one eye on the contralateral eye.
Retrospective chart review of all cases performed by three surgeons between 2002 and 2008. Inclusion criteria were open-angle glaucoma, age 18 years or older, uncontrolled with maximum tolerable medical therapy, treated with SLT in both eyes, and follow-up for more than 6 months. Success was defined as a decrease in IOP of at least 3 mmHg maintaining through the last follow-up without use of any additional medication or laser or incisional surgical intervention.
178 eyes of 89 patients met our inclusion criteria. 67 patients (75.3%) showed the same result, success or failure, in the contralateral eye. Multivariate conditional logistic regression analysis of patients who had a differing results between the two eyes (n=22) showed that pretreatment medication number (p = .030; OR 0.053; 95% C.I. 0.004-0.756), and SLT energy (p = .038; OR <0.001; 95% C.I. 0.000-0.475) were associated with a greater chance of success. In patients whose first eye failed, multivariate Cox proportional hazard analysis comparing those who were successful (n=19) versus failed eyes (n=46) in the second eye showed that a higher baseline IOP (p = .026; hazard ratio(HR) 0.894; 95% C.I. 0.810-0.986) was associated with a greater chance of success.
The result of the first eye is predictive of the result in the contralateral eye. If there is a poor response to SLT in one eye, greater baseline antiglaucoma medications, higher baseline IOP, higher laser power were associated with a greater chance of success. Higher treatment energy may be helpful to obtain better outcomes when applying a SLT to the contralateral eye.
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