The consensual ophthalmotonic reaction following selective laser trabeculoplasty.

Abstract

Purpose : This study aims to evaluate whether a consensual ophthalmotonic reaction occurs in patients receiving selective laser trabeculoplasty (SLT) in only one eye.

Methods : A retrospective chart review was conducted on patients that received SLT treatment for only one eye from January 2015 to August 2016. Patients were excluded if they had any previous history of glaucoma incisional and/or laser procedures, including peripheral iridotomies, in either eye. Patients were also excluded if they required additional laser trabeculoplasty after the initial treatment, had medication changes to either eye during the follow-up period, had no decrease in intraocular pressure (IOP) of the treated eye during the follow-up period, or had Grade I or Grade 0 angle configuration by Shaffer criteria on gonioscopy.

Results : A total of 87 patients were included in the study. The follow-up period was divided into 1-3 months (65 patients), 4-9 months (56 patients), and 12-15 months (32 patients). The average IOP prior to treatment in the eye receiving SLT and in the fellow eye were 20.17 ± 0.49 mm Hg and 17.82 ± 0.55 mm Hg respectively. When comparing groups, there is a statistically significant difference (p=0.0017) in the pre-treatment IOP between the SLT and fellow eye groups. Within the SLT eye group, there was a statistically significant difference in the pretreatment IOP compared to all post-treatment time points. However, for the fellow eye group, there was a statistically significant difference in the pretreatment IOP compared to the IOP at 1-3 month (p<0.0001) and 4-9 months (p=0.006), but not 12-15 months (p=0.05). Linear regression analysis of IOP reduction percentage from pre-treatment IOP between the treated eye and fellow eye showed correlated reductions at 1-3 months (R²= 0.284) and 4-9 months (R²=0.348). At 12-15 months, the correlation in IOP percent reductions decreases (R²=0.118).

Conclusions : When compared to pretreatment IOP, the SLT treated eyes showed statistically significant decrease in mean IOP at all time points, but the fellow eye only showed statistically significant decrease in mean IOP until 4-9 months. The percent reduction in IOP of the fellow eye is correlated to IOP percent reduction in the treated eye, until 4-9 months. Based on these results, SLT shows a consensual ophthalmotonic reaction for up to 4-9 months, suggesting a systemic cellular or biochemical response to SLT.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.