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Junping Li, Christopher Johnson, Clayton Kirk; Long Term Efficacy of Selective Laser Trabeculoplasty Performed by Residents in a Large Veteran Population. Invest. Ophthalmol. Vis. Sci. 2018;59(9):6087.
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To evaluate the treatment outcome of selective laser trabeculoplasty (SLT) performed by residents in a large number of veteran patients with open angle glaucoma or ocular hypertension.
This retrospective chart review was conducted in consecutive veteran patients who had SLT treatment by residents from January 2001 through December 2015 with at least 12 months of follow-up. The change in intraocular pressure (IOP) from baseline was collected at the following time points after laser: week 1 and months 1, 3, 6, and 12. A window of ± 2 weeks is allowed for the 1st month time point and ± 6 weeks allowed for all other time points. Success was defined as ≥ 20% IOP reduction from baseline without additional glaucoma medications, repeat laser trabeculoplasty or glaucoma surgery.
A total of 311 eyes of 215 patients met the inclusion and exclusion criteria. The patient population was predominately male (98%). Caucasians accounted for 66.5% of the patients and African Americans 32.5%. The most common diagnosis was primary open angle glaucoma (78%). Average baseline IOP was 18.46 ± 3.97 with 2.85 ± 1.26 eyedrops. The mean IOP decrease from baseline was 15.81% ± 13.59, 12.06% ± 13.67, 16.24% ± 10.67, 15.51% ±15.87, and 14.67 ± 20.68 at 1 week, 1 month, 3 months, 6 months and 12 months, respectively. The IOP was significantly lower (P<0.01) than the baseline at all time points after laser treatment. Success rates were 45.63%, 39.44%, 44.61%, 42.57%, and 52.56% at 1 week, 1 month, 3 months, 6 months, and 12 months, respectively. Complications were rare, and the most common one was transient IOP elevation in 3.81% of the cases.
We are aware of only two previous studies looking at the results of resident performed SLT: one in 43 eyes, and the other in 118 procedures of 87 patients. Our current investigation involved 311 eyes and confirmed that SLT performed by residents is a safe and effective mode of therapy for open angle glaucoma and ocular hypertension. The mean percentage of IOP reduction in our patients was in the low range of those reported in the literature. This may be explained by the relatively low baseline IOP in our patient population.
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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