Abstract
Purpose :
Studies have reported the clinical benefits of selective laser trabeculoplasty (SLT) among patients with glaucoma. However, there is limited research comparing the effectiveness of SLT across different races, particularly African Americans who are underrepresented in current clinical studies. We conducted a retrospective analysis to investigate differences in the efficacy of SLT by race.
Methods :
A retrospective analysis was performed on patients with glaucoma who received SLT between 2008 to 2022 at the George Washington University. Patients with prior glaucoma procedures or laser were included. Intraocular pressure (IOP) and the mean number of ocular hypotensive medications were recorded preoperatively and postoperatively at 6 weeks, 6 months, and 12 months. The primary outcome was SLT success, defined as IOP reduction of 20% or greater without the use of additional glaucoma medications. Eyes were matched (1:1) based on baseline demographics, IOP, and number of medications. Statistical analysis included chi-squared and independent and paired t-test.
Results :
In our 176-eye cohort (88 white not hispanic, 88 black), the mean age was 68.7 ± 11.4 years. The baseline glaucoma distribution was: primary open angle (88.6%), pigmentary (7.4%), pseudoexfoliation (1.7%), normal tension (1.7%), and juvenile open angle glaucoma (0.6%). Mean baseline IOP for the white and black cohorts were 18.0 ± 4.1 mmHg and 17.8 ± 4.5 mmHg, respectively. Mean baseline number of medications were 1.7 ± 1.3 for the white cohort and 1.9 ± 1.2 for the black cohort, respectively. Mean IOP at 12 months was 13.9 mmHg ± 2.9 (22.5% reduction; p<0.001) for the white cohort and 14.7 mmHg ± 5.1 (17.5% reduction; p<0.001) for the black cohort. Mean medications at one year were 1.9 ± 1.3 (7.2% increase; p>0.05) for the white cohort and 2.1 ± 1.2 (12.8% increase; p>0.05) for the black cohort. Between cohorts, the differences in IOP reduction and change in number of glaucoma medications after SLT at 6 weeks, 6 months, and 1 year were not significant. (p>0.05). SLT success was achieved at 12 months in 44.3% (39/88) of the white not hispanic cohort and 37.5% (33/88) of the black cohort (p>0.05 between cohorts).
Conclusions :
SLT offers comparable efficacy for both White not Hispanic and Black patients. A long-term randomized controlled trial is warranted to establish the clinical benefit of SLT across diverse populations.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.