Abstract
Purpose :
To examine whether long-term use of no drops, steroid drops or NSAID drops had a more significant association with reduction in intraocular pressure (IOP) and number of medications following selective laser trabeculoplasty (SLT) in patients with ocular hypertension or primary open angle glaucoma (POAG) over a 5 year time period in New York City.
Methods :
This was a retrospective chart review of consecutive patients who underwent SLT by two surgeons using identical laser settings having 12 and 24 months of follow-up. Patients must have been diagnosed with ocular hypertension defined as IOP>21 or POAG for whom the clinician decided SLT therapy would be appropriately indicated. Patients were stratified by postoperative regimen. Group 0: no drops (n=132). Group 1: steroid drops (n=67). Group 2: NSAID drops (n=88). IOP was measured using Goldmann applanation tonometry. Patient age, postoperative regimen, preop central corneal thickness (CCT), as well as preop and postop IOP and number of glaucoma medications are reported. Analyses include multiple linear regression models and ANOVA evaluating change from baseline.
Results :
In a multiple linear regression analysis, considering as covariates age, preop MD, preop CH, preop CCT, preop IOP, preop number of meds, the factors that resulted in greater IOP reduction at 12 and 24 month follow-up were older age (p=0.02 and p=0.03, respectively), high preop IOP (p=5.65E-7 and p=0.002, respectively) and lower corneal thickness at 12 month follow-up only (p=0.04).The analysis also showed that the NSAID treatment group had a mean 12-month IOP change of +2.36 mmHg (P=0.0021) and 24-month IOP change of +3.60 mmHg (P=0.005) when compared to the 12 and 24-month IOP changes in both other treatment groups. In an ANOVA analysis, the average 12 and 24-month IOP difference from baseline was -3.33 and -2.85 mmHg respectively for group 0, -2.40 and -3.72 mmHg respectively for group 1 and -2.04 and -1.78 mmHg respectively for group 2.
Conclusions :
Factors that resulted in greater IOP reduction at 12 and 24 months follow-up included high preop IOP, treatment with either no drops or steroid drops and advanced age. At 12 months follow-up, patients with lower corneal thickness had a greater IOP reduction.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.