Effect of central corneal thickness on the long-term outcome of selective laser trabeculoplasty as primary treatment for ocular hypertension and primary open-angle glaucoma.

PURPOSE: To determine if central corneal thickness (CCT) impacts the intraocular pressure (IOP)-lowering effect of selective laser trabeculoplasty (SLT) in patients with ocular hypertension (OHT) and primary open-angle glaucoma (POAG). METHODS: A retrospective chart review of consecutive patients, who underwent SLT as primary treatment for OHT and POAG, between 2002 and 2005, was performed. Partial correlation analysis was performed to correlate the CCT to the percentage of IOP reduction at 3 to 30 months after SLT. Independent samples t test was performed to compare mean percentage of IOP reduction in eyes with CCT less than 555 µm versus CCT 555 µm or greater. RESULTS: Eighty eyes of 47 patients were identified. The partial correlation coefficient value between the CCT and percentage of IOP reduction after SLT at 3 months was -0.253 (P = 0.025), at 12 months it was -0.22 (P = 0.049), and at 30 months it was 0.301 (P = 0.007). Independent samples t test showed that the mean percentage of IOP reduction in eyes with thinner corneas (CCT < 555 µm) was greater than that in thicker corneas (CCT ≥ 555 µm) at 3-, 6-, 9-, 12-, and 30-month post-SLT (P < 0.05). CONCLUSIONS: In patients with POAG and OHT, percentage of IOP reduction after SLT was significantly greater in eyes with thinner corneas (CCT < 555 µm). These findings indicate that patients treated with SLT as primary therapy who had thinner corneas demonstrated better IOP control for at least 30 months after SLT.

Effect of prior cataract surgery on the long-term outcome of selective laser trabeculoplasty.

OBJECTIVE: To determine if pseudophakia affects selective laser trabeculoplasty (SLT) intraocular pressure (IOP) lowering effect. METHODS: A retrospective chart review was performed on 94 eyes of 75 consecutive patients who underwent SLT as primary treatment for ocular hypertension and primary open-angle glaucoma between 2002 and 2005 and completed at least 30 months follow up. Patients were excluded if they required additional glaucoma medications, laser, or ocular surgery during the follow-up period. Patients were categorized as phakics or pseudophakics. Independent-samples t-test was performed to compare the mean percentage of IOP reduction at 3, 6, 12, 18, and 30 months after SLT between the phakic and pseudophakic groups. RESULTS: Seventy-six phakic and 18 pseudophakic eyes were included. IOP reduction in phakic group was 27.4% (2 week), 29.8% (3 months), 27.7% (9 months), 27.4% at (12 months) and 27.3% at (30 months). In pseudophakic patients, the mean IOP reduction was 19.8% (2 weeks), 26.5% (3 months), 23.2% (9 months), 22.5% (12 months), and 25.9% (30 months). An independent-sample t-test compared the percentage of IOP reduction between the phakic and pseudophakic groups and revealed higher percentage of IOP reduction in the phakic group at 2 weeks by 7.6% (P = 0.01). P value for difference was 0.34 (3 months), 0.25 (6 months), 0.18 (9 months), 0.12 (12 months), 0.36 (18 months), and 0.7 (30 months) after SLT. CONCLUSIONS: SLT response was delayed in pseudophakic compared to phakic patients, while the long-term effectiveness of SLT is the same in both groups.

A comparison of the intervisit intraocular pressure fluctuation after 180 and 360 degrees of selective laser trabeculoplasty (SLT) as a primary therapy in primary open angle glaucoma and ocular hypertension.

OBJECTIVE: To determine and compare the effect of 180 and 360 degrees of selective laser trabeculoplasty (SLT) treatment as a primary therapy on the intervisit intraocular pressure (IOP) fluctuation in patients followed up for a period of 2 years without any further medical or surgical intervention. METHODS: Retrospective chart review of patients with ocular hypertension and primary open angle glaucoma who received SLT as primary therapy without any subsequent medical or surgical intervention. IOP before SLT and postlaser IOP at all the visits during the follow-up period of months 6 to 24 was determined. The standard deviation (SD) of the mean IOP was used as a surrogate for IOP fluctuation. RESULTS: Forty-one eyes were treated by SLT, 19 eyes in the 180-degree group and 22 eyes in the 360-degree group. The mean reduction in IOP at 2 years was 28% in 180-degree group and 35% in 360-degree SLT group. After the SLT, the 360-degree SLT group had a lower IOP fluctuation compared with the 180-degree SLT group over the follow-up period of months 6 to 24. The percentage of eyes with intervisit IOP fluctuation (SD)

Efficacy of multiple selective trabeculoplasty in open-angle glaucoma

OBJECTIVE: To determine the reduction in intraocular pressure (IOP) of multiple selective laser trabeculoplasty (SLT) in eyes with open-angle glaucoma (OAG) and ocular hypertension (OHT). METHODS: Forty-nine OAG eyes that received multiple SLTs were retrospectivel]j studied. The first and second SLT treated 180 degrees and the third treat! 180 to 360 degrees of the trabecular meshwork. Main outcome (response rate)] was IOP reduction of a3 mm Hg from baseline at 6 months after each SLT.Only patients followed up for at least 6 months were included. CONCLUSION: Multiple selective SLT successfully lowers IOP. A second SLT lowered IO1 by 19 percent from baseline IOP after 6 months and a third by 47 percent after another f months. Eyes with baseline IOP >21 mm Hg had greater IOP reduction; higher response rates for each SLT compared to those with baseline IOP ? 21 mm Hg.