Abstract
Purpose :
Selective laser trabeculoplasty (SLT) may represent a cost-effective treatment for glaucoma care in low-resource regions. To explore this we performed a retrospective chart review to learn about short-term intraocular pressure (IOP) results in the first group of patients in Western Tanzania to receive SLT for chronic primary open angle glaucoma (POAG) or isolated ocular hypertension (OHT) unresponsive to pressure lowering drops.
Methods :
Patients at Bugando Medical Center (BMC) in Mwanza, Tanzania who underwent SLT with a Lumenis Selecta II laser over a one-week period and presenting six-weeks later for follow-up were included. Data collected included age, gender, IOP before SLT, central corneal thickness (CCT), energy and number of applications, and IOP within two hours of SLT and six-weeks later. Visual acuity (VA) was obtained before SLT and at the six-week follow-up. IOP was measured using an Icare tonometer (Icare, USA).
Results :
A total of 14 eyes of 12 patients (mean age 60.2 years, 83% male) were treated. Mean IOP prior to SLT was 22.1 ± 9.4 mmHg. CCT was <555 μm in all patients where CCT was measured. All eyes received laser over 360° of the trabecular meshwork at energy levels ranging from 0.7-1.2 mJ per pulse except for one eye treated 180° due to limited patient tolerance. No pressure spikes were observed immediately after treatment. Nine patients (eleven eyes) returned for the six-week follow-up. The mean IOP drop six-weeks post-SLT was 8.5 ± 7.0 mmHg. Five patients (six eyes) had a greater than 30% decrease and three patients (four eyes) had an 11-30% decrease in IOP compared to baseline. The IOP in the fellow eye of five patients six-weeks post-SLT was lower compared to pre-SLT, with a mean IOP drop of 8.0 ± 4.8 mmHg. No patients experienced a decrease in VA at the six-week follow-up.
Conclusions :
Selective laser trabeculoplasty of twelve patients with POAG or OHT at BMC resulted in a notable pressure lowering effect in eight of nine patients evaluated at the six-week follow-up. No adverse effects were noted. Results showing one patient who did not have a pressure lowering effect may be attributed to challenges achieving a full treatment of 360°. Our data suggests additional studies of the long-term efficacy of SLT for POAG and OHT in Western Tanzania is warranted in light of the high cost of IOP lowering medication and limited access to specialist care in the region.
This is a 2021 ARVO Annual Meeting abstract.