Abstract
Purpose :
While its pathophysiology is not fully understood, there are a number of genetic and clinical risk factors associated with glaucoma; the primary risk factor is elevated intraocular pressure (IOP). Laser trabeculoplasty is a widely-used treatment method for glaucoma because it effectively reduces IOP without bearing the greater risks of invasive surgery. Selective laser trabeculoplasty (SLT) is a core competency skill that ophthalmology residents learn; however, competency in SLT is not well-defined, as experience in glaucoma procedures is variable by program. SLT is typically performed one eye at a time. During the COVID-19 pandemic, in-office visits were minimized and surgeries were limited to only the most vision-threatening at the University of Chicago. Bilateral SLT on the same day was used to keep IOP controlled during this period, while patients could not be monitored as frequently and surgeries were postponed. The goal of this study is to assess the effectiveness and safety of same-day bilateral resident-performed SLT in comparison to reported statistics of attending-performed SLT in the literature.
Methods :
A retrospective chart review of patients who underwent simultaneous bilateral SLT between January 2019-May 2021 was performed to quantify the effectiveness and safety of the procedure compared to published rates in the literature. Specifically, we examined the intraocular pressure (IOP) at the visits before and after the SLT procedure, type of glaucoma diagnosis, Age, Sex, and complications (IOP elevation, iritis, macular edema).
Results :
Preliminary data included a total of 51 patients (of which 32 were female) and 108 eyes (3 patients underwent SLT twice). Average age was 66. Average IOP was 18.7 mmHg (SD 5.0) on visit prior to SLT and 17.6 (SD 6.5) on day of SLT with the average IOP decreasing to 15.9 (SD 5.0) and 15.7 (SD 4.5) on the first and second follow-up. There were 2 patients in whom we documented IOP spikes on the visit after SLT was performed, one of whom had documented compliance issues on multiple visits. No macular edema or iritis was noted.
Conclusions :
We found a similar rate of decrease in IOP after bilateral SLT by residents compared to prior studies by attending physicians with very few complications. Resident-performed simultaneous bilateral SLT appears to be an effective and safe option for IOP-lowering.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.