Abstract
Purpose :
Determine the longer-term efficacy of selective laster trabeculoplasty (SLT) monotherapy among individuals of Hispanic descent with mild-moderate open-angle glaucoma.
Methods :
Adults with mild-moderate open-angle glaucoma (MD ≥-12db) had baseline intraocular pressure (IOP) assessed after a 30-day medication washout. All eyes then underwent 360° SLT performed by a single surgeon (WES). Patients were followed up to 3 years post-operatively.
Results :
55 eyes (26R, 29L) of 35 subjects (14M, 21F, mean age: 62y) were enrolled. Self-reported race: 22 Hispanic, 7 white, 5 black and 1 Asian. Of these, 3 eyes had an IOP after washout that warranted immediate lowering with topical therapy. These subjects were withdrawn from the study. Of remaining subjects, mean follow-up was 73 weeks (range: 12 wks-3 yrs). Mean IOP for the cohort decreased significantly from baseline at all time points (R/L 1yr: -4.4±1.2/-8.0±1.2; 2yr: -2.7±0.6/-6.7±2.3 3yr: -3.0±0.5/-4.6±1.8; mean±sem mmHg, P<0.05, 2-tail t-test). There was no significant difference between R and L eyes nor among the 3 post-operative time points. IOP reduction from baseline for Hispanic/non-Hispanics at 1yr was 21%/23% (p=.8) and 3yr was 12%/22% (p=.3). Mean IOP change was significantly correlated to baseline IOP within the first year, but not afterward. 10 subjects (29%) required topical or additional laser therapy to adequately control their IOP. The need for additional therapy arose within 15 months of SLT in 90% of cases. Change in IOP was not significantly different between subjects that had previously used prostaglandin or other topical therapy and treatment naive subjects at the 1yr, 2yr or 3yr time points. There were no serious complications, but 2 patients experienced post-operative IOP spikes that required intervention.
Conclusions :
SLT monotherapy is effective in lowering the IOP of Hispanic patients with open-angle glaucoma for up to 3 years. Approximately one-third of our cohort required additional therapy to adequately control IOP. Prior topical therapy did not significantly influence the effectiveness of SLT.
This is a 2020 ARVO Annual Meeting abstract.