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S. Vishnu, Y. Catoira-Boyle, D. WuDunn, J. Hoop; Efficacy of Selective Laser Trabeculoplasty After Argon Laser Trabeculoplasty in Open Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3971. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the efficacy of Selective Laser Trabeculoplasty (SLT) in patients with Open Angle Glaucoma who have had prior Argon Laser Trabeculoplasty (ALT).
We performed a retrospective chart review of 31 subjects with open angle glaucoma who underwent SLT after ALT. All patients were refractory to medical treatment, had inadequate or short-lived responses to ALT and had deferred surgery either due to personal choice or being poor surgical candidates. Paired t-tests were used to compare pre- and post-procedure intraocular pressure (IOP).
Of the 31 subjects, 4 had bilateral SLTs and 3 had repeat SLTs (total of 38 SLT procedures). The mean ± SD age of patients in the study was 72.5 ± 10.3 years; mean number of medications were 2.92 (SD 1.2). Mean pre-ALT IOP for all eyes was 18.8 ± 4.0 mm Hg, and mean post-ALT IOP at 2 months was 17.4 ± 3.5 mmHg (7.4% reduction, p= 0.0058). For all SLT procedures, IOP decreased from a mean of 18.5 ± 4.9 mmHg to 16.8 ± 5.4 mmHg at 2 weeks post-SLT. At 2 months post-SLT mean IOP was 16.1 ± 4.1 mmHg (13.0% decrease p=0.00005). After a mean follow up of 7.2 ± 4.2 months, the mean IOP was 15.8 ± 4.6 (14.6% reduction, p=0.0000007). Even after excluding fellow eyes and repeat SLTs (31 eyes, 31 subjects), there was significant reduction in IOP from pre-SLT mean of 18.3 ± 5.1 to 15.8 ± 4.0 (p=0.0002) at 2 months post-SLT, and 16.3 ± 5.1 (p=0.0003) at 7.1 ± 3.8 months follow up.
In patients previously treated with ALT, SLT significantly lowered mean IOP by about 13%. SLT may be a valuable and safe treatment option in patients with open angle glaucoma who are poor surgical candidates. Success of the procedure may not be affected by previous treatment with ALT.
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