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Tony Realini, Hazel Shillingford-Ricketts, Darra Burt, Goundappa K Balasubramani; Efficacy of Repeat Selective Laser Trabeculoplasty in Afro-Caribbeans with Primary Open-Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3458.
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To evaluate the intraocular pressure (IOP) lowering effect of repeat selective laser trabeculoplasty (SLT) in Afro-Caribbean primary open-angle glaucoma (POAG) patients.
The West Indies Glaucoma Laser Study (WIGLS) is an ongoing prospective multinational evaluation of SLT’s monotherapy efficacy for POAG in an Afro-Caribbean population. Initial SLT (SLT1; 360 degrees) was performed in 143 eyes of 72 subjects after washout of all medications. Repeat SLT (SLT2; also 360 degrees) was performed when target IOP (minimum 20% reduction from pre-SLT baseline) was exceeded at two consecutive time points. IOP reductions and median survival time of SLT1 and SLT2 were analyzed.
To date, 37 eyes of 20 subjects have undergone SLT2. In these 37 eyes that failed initial SLT within the first 24 months, mean IOP reduction at baseline (after medication washout and before SLT1) was 20.7 (2.8) mmHg. During the periods 1-6 months, 7-12 months, and 13-18 months post-SLT1, mean IOP was 15.5 (3.4) mmHg, 16.7 (3.4) mmHg, and 19.5 (2.8) mmHg, respectively. At the same time periods post-SLT2, mean IOP was 16.7 (2.3) mmHg (p=0.078 versus SLT1 months 1-6), 17.4 (2.8) mmHg (p=0.113 versus SLT1 months 7-12), and 16.3 (1.9) mmHg (unable to compare to SLT1 as no eyes yet have follow-up >12 months after both SLT1 and SLT2). Among these 37 early-failing eyes, the median survival times of SLT 1 and SLT2 were 15.2 months and 12.7 months, respectively. No safety issues with SLT2 were identified.
In this subset of eyes from WIGLS that failed SLT1 within 24 months, repeat SLT lowered IOP comparably to initial SLT, restoring the level of IOP control achieved after initial SLT. Repeat SLT’s IOP-lowering effect endured approximately as long as initial SLT’s effect.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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