Intraocular pressure-lowering medications and long-term outcomes of selective laser trabeculoplasty

David M. Woo*, Paul R. Healey, Stuart L. Graham, Ivan Goldberg

*Corresponding author for this work

    Research output: Contribution to journalArticle

    24 Citations (Scopus)

    Abstract

    Background: To investigate the effects of current intraocular pressure-lowering medications on the efficacy of selective laser trabeculoplasty. Design: Retrospective chart review of records from an urban glaucoma clinic in Sydney, Australia. Participants: Patients who received their first selective laser trabeculoplasty between 2002 and 2005 were studied (grouped from 0 to 3 according to the number of pre-selective laser trabeculoplasty medications, and followed for 5 years). Those with previous argon laser therapy, trabeculectomy or angle-closure were excluded. Methods: Selective laser trabeculoplasty (Ellex) used to deliver 180 or 360 degree of treatment, under the same protocol. Main Outcome Measures: Responders were defined by ≥20% reduction from baseline intraocular pressure. Data were censored when pressure-lowering intervention was required. The mean intraocular pressure, survivor, response rate, number and type of medications were compared. Results: There were 206 patients with ocular hypertension, primary, pseudo-exfoliation, or pigmentary glaucoma who usednone (n=20), one (n=33), two (n=61) or three or more (n=92) pre-selective laser trabeculoplasty topical anti-glaucoma medications. The mean baseline intraocular pressures for each group was 23.7, 22.2, 20.7 and 20.4mmHg, respectively (P=0.061). Post-treatment mean intraocular pressure was 17.9, 17.7, 15.5, and 15.7mmHg; percentage reduction was similar between groups (23.6-25.6%, P=0.20). Kaplan-Meier survival analysis showed comparable survival rates across groups (P=0.445). At 60 months, 11.1, 17.1, 30.5 and 11.5% of responders remained in each group. Higher proportions of patients in groups 2 and 3 required further laser or surgery. Conclusion: The number of pre-selective laser trabeculoplasty medications did not affect the intraocular pressure-lowering effectiveness of selective laser trabeculoplasty; however, groups on more medications required more pressure-lowering interventions.

    Original languageEnglish
    Pages (from-to)320-327
    Number of pages8
    JournalClinical and Experimental Ophthalmology
    Volume43
    Issue number4
    DOIs
    Publication statusPublished - 1 May 2015

    Keywords

    • glaucoma
    • intraocular pressure
    • selective laser trabeculoplasty

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