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L. F. Jindra, J. A. Donnelly, A. Gupta, E. M. Miglino; Selective Laser Trabeculoplasty as Primary and Secondary Therapy in Patients With Glaucoma: 8 Year Experience. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4428.
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To evaluate Selective Laser Trabeculoplasty (SLT) as primary and secondary therapy, to decrease intraocular pressure (IOP) and glaucoma medication (meds) usage.
Retrospective chart review was performed on 1363 and 945, respectively, of 3013 eyes treated with SLT over 8 years. Two-tailed paired t-test was used to compare maximum pre- and post-procedure IOP and number of meds.
Mean follow-up was 750 and 515 days, respectively. For primary therapy, IOP decreased 31% from mean of 18.8mm Hg to 13.0mm Hg. For IOP control, 87 eyes (6%) required one repeat SLT (15 eyes required multi repeat). After one SLT, 16 eyes (1%) were on meds to control IOP. For SLT as primary (initial) treatment of glaucoma, cumulative probability of success over 7 years was 92%. For secondary therapy, IOP decreased by 22% from mean of 19.8mm Hg to 15.4mm Hg; meds decreased by 60% from a mean of 2.3 to 0.9 meds. For IOP control, reduction in meds' side effects, improvement in compliance, and / or decrease in need for meds, 367 eyes (38%) required one repeat SLT (59 eyes required multi repeat). After one SLT, 540 eyes (57%) were on no meds; 171 eyes (18%) were on less meds (but not zero); 207 eyes (22%) were on the same number of meds; and 27 eyes (3%) were on more meds to control IOP. For SLT as secondary (adjunct) treatment of glaucoma, cumulative probability of success over 7 years was 64%. Results were significant with p<0.01.
In this large long-term series, SLT significantly lowered IOP and decreased number of meds as, primary and secondary therapy, in patients with glaucoma.
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