Selective laser trabeculoplasty reduces mean IOP and IOP variation in normal tension glaucoma patients

Clinical Ophthalmology 01/2010;
Source: DOAJ


Mohammed K El Mallah1, Molly M Walsh2, Sandra S Stinnett2, Sanjay G Asrani21Ocala Eye, Ocala, Florida, USA; 2Duke University Eye Center, Durham, North Carolina, USAPurpose: To evaluate the effect of selective laser trabeculoplasty (SLT) in normal tension glaucoma (NTG) patients.Patients and methods: A retrospective review was performed of NTG patients who had undergone SLT at the Duke University Eye Center between 12/2002 and 7/2005. For each eye of each patient at pre-laser and post-laser time points, the IOP measurements were summarized by mean, standard deviation, and range. Then for each of these descriptive statistics, the differences between pre-laser and post-laser values were obtained. Statistical analysis was performed using a random effects model. Main outcome measures: difference in mean IOP, standard deviation of IOP, and range of IOP.Results: Thirty-one eyes of 18 patients were included for analysis. The average of the mean ­pre-operative IOP measurements was 14.3 ± 2.6 mmHg compared to 12.2 ± 1.7 mmHg (P < 0.001) post-operatively. The mean pre-operative standard deviation was 1.9 ± 0.9 mmHg compared to 1.0 ± 0.6 mmHg (P = 0.002) post-operatively while the mean IOP range prior to treatment was 4.5 ± 2.5 mmHg compared to 2.5 ± 1.9 mmHg (P = 0.017) after treatment.Conclusion: In this pilot study, SLT was found to lower mean IOP and intervisit IOP ­variation in NTG patients. Given the importance of IOP variation and its association with glaucoma ­progression, measurement of IOP variation following treatment with SLT may be considered.Keywords: SLT, NTG, laser, glaucoma

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    ABSTRACT: To evaluate the efficacy of selective laser trabeculoplasty (SLT) versus argon laser trabeculoplasty (ALT) in lowering the intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension secondary to pseudoexfoliation. Multicentered randomized clinical trial. A total of 76 eyes from 60 patients with pseudoexfoliation and uncontrolled IOP were recruited from 5 Canadian academic institutions. Patients with prior laser trabeculoplasty, ocular surgery within 6 months, previous glaucoma surgery, an advanced visual field defect, current steroid use, and monocular patients were excluded. Eyes were randomized to receive either 180-degree SLT or 180-degree ALT by a nonblocked randomization schedule stratified by center. The primary outcome was the change in IOP at 6 months versus baseline and secondary outcomes included change in number of glaucoma medications after laser. Baseline variables included age, sex, angle grade, angle pigmentation, and number of glaucoma medications. Of the 76 eyes, 45 eyes received SLT and 31 eyes received ALT. The overall age was 72.9 years (65% females). The baseline IOPs in the SLT and ALT groups were 23.1 and 25.2 mm Hg, respectively (P=0.03). The IOP reduction 6 months after SLT was -6.8 mm Hg.
    Journal of glaucoma 07/2013; 24(5). DOI:10.1097/IJG.0b013e31829e55e4 · 2.11 Impact Factor