Abstract
Abstract: :
Purpose: SLT is a q–switched, melanosome specific laser used to lower intraocular pressure (IOP) in open angle glaucoma (OAG). A large sector of patients at The University of Chicago Hospitals (UCH), and nationwide, have both diabetes and OAG. The purpose of this study is to assess the change in IOP following SLT in diabetics versus non–diabetics. Methods: This is a retrospective chart review of 48 consecutive eyes with open angle glaucoma, which had SLT performed at UCH. The patients were divided into two groups based on pre–operative IOP, which was determined to modulate response to SLT. Group A had a pre–operative IOP of <22 mmHg, and Group B had a pre–operative IOP of >=22 mmHg. Additional data gathered included three pre–operative IOP measurements and a one month post–operative IOP measurement. Univariate and multivariate analyses were performed, and statistical significance was established. Results: Group A included 39 eyes. Of those, 17 patients had diabetes, and a mean pre–operative IOP of 18.7 mmHg, and 22 patients were non–diabetics, with a mean pre–operative IOP of 17.6 mmHg. Group B included 9 eyes. Four of those patients had diabetes, and a mean pre–operative IOP of 24 mmHg, while 5 patients were non–diabetics, with a mean pre–operative IOP of 24.6 mmHg. The one month follow–up mean IOP for Group A was: Diabetics 18.5 mmHg (0.2 mmHg reduction) and Non–Diabetics 17.3 mmHg (0.3 mmHg reduction). There was a difference of 0.1 mmHg (p<.005) between Diabetics and Non–Diabetics in Group A. The one month follow–up mean IOP for Group B was: Diabetics 21.5 mmHg (2.4 mmHg reduction) and Non–Diabetics 17.8 mmHg (6.8 mmHg reduction), with a difference of 4.4 mmHg (p=.14) between the Diabetics and Non–Diabetics in Group B. Conclusions: There was a minimal difference in one–month post–operative IOP response between diabetics and non–diabetics in patients whose pre–operative IOP was less than 22 mmHg. On the other hand, this study suggests a pronounced difference may exist in the one–month postoperative IOP response between diabetics and non–diabetics in patients whose preoperative IOP is greater than 22mmHg. In conclusion, diabetic patients may show less response to SLT treatment if their pre–operative IOP is greater than 22 mmHg compared to non–diabetics in this same group.
Keywords: clinical (human) or epidemiologic studies: biostatistics/epidemiology methodology • diabetes • laser