Abstract
Purpose: :
To evaluate the efficacy and repeatability of selective laser trabeculoplasty (SLT) in open angle glaucoma.
Methods: :
A retrospective chart review of 98 eyes that underwent SLT at Wills Eye Hospital performed by 4 different physicians was conducted. Success of lowering intraocular pressure (IOP) was defined as 20% reduction from pre–operative IOP. Data collected included age, sex, pre–operative IOP, number of pre–operative medications, if patients have had previous argon laser trabeculoplasty (ALT) or SLT or intraocular surgery, glaucoma type, post–op one hour IOP to post–op IOP measurement at 18 months and complications.
Results: :
There were 98 eyes that underwent SLT with an average pre–operative IOP of 21 (SD= 5.7). The average age of patients in the study was 70 years. Eighty–seven percent of patients had a 360 degree treatment and 13% had 180 degree treatment. Primary open angle glaucoma comprised 76.5% of treatment eyes, 10% of eyes had pseudoexfoliation glaucoma, 7% had pigmentary glaucoma, uveitic glaucoma and ocular hypertension each comprised 3%. Thirty–one percent of eyes had had a previous SLT treatment, 33% had had a previous ALT treatment, and 15% of eyes had had previous ocular surgery. The only recorded complication was one–hour IOP spike in 8% of eyes that resolved with oral or topical medications. Success as defined as 20% reduction was highest at 4–6 weeks follow–up at 63% (n=62) and gradually reduced to 47% (n=15) at 18 month follow–up. There was no significant correlation between success of reduction of IOP at 4–6 weeks follow–up and previous SLT treatment (Pearson correlation=0.148, p=0.252). There was also no significant correlation between success at 4–6 weeks follow–up and previous ALT treatment or previous ocular surgery (Pearson correlation=0.130, p=0.312, and Pearson correlation= –0.148 with p=0.251 respectively).
Conclusions: :
SLT may be a valuable and safe treatment option in patients with open angle glaucoma with highest success of reduction of IOP at 4–6 weeks post–operatively. Patients need continued follow–up because the treatment effect reduces over time. Success of the procedure may not be affected by previous treatment with SLT, ALT, or ocular surgery.
Keywords: laser • trabecular meshwork