Abstract
Purpose: :
To examine the effectiveness of Selective Laser Trabeculoplasty (SLT) as primary treatment of glaucoma.
Methods: :
A retrospective chart review was performed on 474 out of 1029 eyes in a consecutive case series from patients treated with SLT as primary treatment for glaucoma between January 2002 and January 2005. Intraocular pressure (IOP) for 60 eyes was retrospectively followed for 3 years at 6 month intervals post–SLT. Eyes which required re–treatment with SLT and those which required initiation of topical hypotensive medication were identified.
Results: :
This group included data from 474 eyes. The study subjects were 57% female with average age of 67.8 years (range: 26.8 – 95.9); mean follow–up was 378 days (range: 4 – 1162). The IOP decreased from a mean of 20.4 mmHg +/– 4.0 (range: 12 – 36) to 13.4 mmHg +/– 3.3 (range: 6 – 32). This represented a 35% mean decrease in IOP or 7.0 mmHg +/– 3.2 (99% CI: 6.7 – 7.5) and was significant with a p–value < 0.0001. For 60 eyes that were followed for 3 years, the mean follow up was 954 days. The average decrease in IOP was 31.2% at 1 year, 33.6% at 2 years, and 34.3% at 3 years (p<0.01). After primary SLT, 15 eyes out of 474 eyes required re–treatment with SLT (5 of these needed meds) – gross laser failure rate was 15/474 (3.2%); net laser failure rate was 10/474 (2.1%). After primary SLT, 18 eyes out of 474 eyes required initiation of topical hypotensive medication (5 of these needed retreat SLT) – gross meds failure rate was 18/474 (3.8%); net meds failure rate was 13/474 (2.7%). After primary SLT, 5 eyes out of 474 eyes (1.1%) required both meds and repeat SLT. These results were significant with a p–value < 0.01.
Conclusions: :
In patients treated with SLT as primary therapy for glaucoma, mean reduction in IOP was 35%. SLT as a primary treatment was effective in maintaining decreased IOP (average mean reduction of 32.7%) over 3 years. Gross failure of SLT as primary treatment (another intervention needed post SLT– either meds, repeat SLT, or both) was 28/474 (5.9%) and net failure of SLT as primary treatment (meds needed after retreat SLT) was 3/461 (0.7%). In this series, SLT as a primary treatment was effective both as initial and long term therapy in patients with glaucoma.
Keywords: laser • clinical (human) or epidemiologic studies: systems/equipment/techniques • clinical (human) or epidemiologic studies: outcomes/complications