Abstract
Purpose :
To evaluate the effectiveness of selective laser trabeculoplasty (SLT) in patients who experienced sustained intraocular pressure (IOP) elevation associated with anti-vascular endothelial growth factor (VEGF) therapy.
Methods :
A retrospective chart review was conducted on patients who received SLT for sustained IOP elevation following one or more intravitreal anti-VEGF injections at a single academic center between January 2013 and June 2022. Patients with history of vitreoretinal or glaucoma surgery, angle-closure or neovascular glaucoma, or less than 6 weeks of follow-up were excluded. Primary outcome measures included IOP and medication use at 1-week, 1-month, 3-month, 6-month, 12-month, 18-month, and 24-month follow-up time frames. The secondary outcome measure included the time to failure, which was defined as less than 20% reduction in IOP or increase in medication use compared to baseline over two consecutive visits or the need for additional laser or surgical treatment.
Results :
In total, 34 eyes of 32 patients were identified. At baseline, the mean IOP was 25.1 ± 5.9 mmHg on 2.5 ± 1.3 medications. There was a significant reduction in mean IOP but no significant reduction in mean medication use at all follow-up time points. The mean IOP was 17.6 ± 4.2 mmHg (P < 0.001) on 2.8 ± 1.3 medications (P = 0.137) at 6-month follow-up (n = 25 eyes), 18.4 ± 7.0 mmHg (P < 0.001) on 2.6 ± 1.5 medications (P = 0.479) at 12-month follow-up (n = 21 eyes), and 17.5 ± 8.2 mmHg (P = 0.009) on 3.1 ± 0.9 medications (P = 0.313) at 24-month follow-up (n = 11 eyes). The overall success rates were 50.0% at 6 months, 31.4% at 12 months, and 22.9% at 24 months. 13 of 34 (38.2%) eyes required additional laser or surgical treatment throughout the 24-month follow-up period.
Conclusions :
SLT may be an effective adjunctive treatment for sustained IOP elevation associated with anti-VEGF therapy. However, additional studies are needed to further characterize the efficacy of SLT for this patient population.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.