Abstract
Abstract: :
Purpose:To assess the effectiveness of Selective Laser Trabeculoplasty (SLT) in lowering intraocular pressure (IOP) in patients with steroid–induced ocular hypertension. Methods:A retrospective review was performed on six patients (6 eyes) with IOP elevation following intravitreal triamcinolone acetonide (4.0 mg/ 0.1 ml) injections for macular edema (5 patients) or central retinal vein occlusion (1 patient). Two patients had preexisting open angle glaucoma and one patient had preexisting ocular hypertension. The time between intraocular corticosteroid injection and subsequent ocular hypertension ranged from 5 to 24 weeks. Following unsuccessful maximum tolerated medical therapy, patients underwent an SLT in one eye between April 2003 and October 2004. IOP was measured at 4 wks pre–laser, just prior to laser, and at 1 hr, 1 wk, 1 month and 3 months post–laser. Intraocular pressures at these different time points were compared using a two–tailed t–test and Repeated Measures (RM) ANOVA. Results:Six patients were on a mean of 3.1 (± 0.8) ocular hypotensive medications prior to the SLT. Mean IOP±SD decreased following SLT from 39.7±7.1 mmHg pre–op, to 25.3±7.8 mmHg at 1 wk post–op (p<0.02), and 26.5±9.4 mmHg at 1 month post–op (p<0.025), and 24.8±11.3 mmHg at 3 months post–op IOP (p< 0.02). One patient underwent two SLT procedures, the second was 2 wks after initial SLT, and one patient underwent a second SLT after the 3 month post–laser visit. IOP in the fellow eyes of all patients was unchanged (p>0.2, RM ANOVA). Conclusions:SLT lowers IOP in patients with steroid–induced ocular hypertension. Repeat SLT treatments may be necessary. SLT is a temporizing procedure to consider in patients with steroid–induced ocular hypertension.
Keywords: intraocular pressure • laser