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M. B. Hymowitz, M. E. Keshet, A. A. Madu, N. Elkin; The Efficacy of Selective Laser Trabeculoplasty in Hispanic and African-American Patients in the Bronx, NY. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4437.
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To evaluate the efficacy of Selective Laser Trabeculoplasty (SLT) in Hispanic and African-American patients treated in an ophthalmology residency program in the Bronx. To our knowledge, this is the first study investigating the usefulness of SLT in a sub-population.
A retrospective chart review was performed evaluating the change in intraocular pressure (IOP) in patients pre-laser and 1-4 weeks (wks) and 6 wks-3 months (mo) post-laser, from Sept '07 - Sept '09, at Jacobi Medical Center. The residents were supervised by the same glaucoma specialist. Age, race, gender, type of glaucoma, medication compliance, number of drops used pre- and post-laser, prior surgeries and/or lasers, amount of pigment in the trabecular meshwork, angle treated, laser spots applied, cup-to-disc (C/D) ratio, angle appearance, and energy settings were documented. Patients were excluded if they did not have a proper follow-up or were not African-American or Hispanic. A two-tailed paired t-test was performed to analyze the data.
Fifty-one charts were reviewed and 35 eyes were included in the study, 19 females (54%) and 16 males (46%), with a mean age of 70 years (53-84 years.) Of 35 eyes, 20 (57%) were African-Americans and 15 (43%) were Hispanics. The indication for laser was visual field progression on maximum medications or poor compliance with drops. Average number of drops used pre- and post-laser was 3.7. Twenty-eight eyes (80%) had advanced primary open angle glaucoma, 5 (14%) had normal tension, 1 (3%) had mixed-mechanism, and 1 (3%) had pigment dispersion. Eleven eyes (30%) had undergone cataract extraction, 1 eye (3%) trabeculectomy, 4 eyes (11%) argon laser trabeculoplasty, and 4 eyes (11%) peripheral iridotomy. Subjectively, the average amount of pigment in the angle was 1.8+ (1-4+) and the average C/D was 0.8. The average number of spots applied was 86, the energy ranged from 0.6-1.4 mJ, and 270° of the angle were treated in all eyes. The average IOP pre-laser was 18 mmHg. At 1 - 4 wks post-laser the IOP was 13.9, and at 6 wks - 3 mo the IOP was 12.7. The average decrease in IOP pre- to 1-4 wks post-laser was 4.2 ± 3.6mmHg (23.3%) (p < 0.001). The average decrease in IOP pre- to 6 wks - 3 mo post-laser was 5.5 ± 3.5mmHg (30.6%) (p < 0.001).
SLT is an effective procedure to perform in Hispanic and African-American patients with advanced glaucoma to decrease IOP.
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