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Selective laser trabeculoplasty in exfoliative glaucoma eyes with prior argon laser trabeculoplasty
Author(s) -
Ilveskoski Lotta,
Taipale Claudia,
Tuuminen Raimo
Publication year - 2020
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.14136
Subject(s) - medicine , glaucoma , intraocular pressure , ophthalmology
Purpose To explore the efficacy of selective laser trabeculoplasty ( SLT ) within eyes with exfoliative glaucoma and history of prior argon laser trabeculoplasty ( ALT ). Methods A single‐centre trial consisting of 47 patients (47 eyes) with uncontrolled exfoliative glaucoma. The main outcome measure was intraocular pressure ( IOP ) reduction 3 and 9 months after SLT . Treatment success was defined as reduction from the preoperative IOP by 20% and 2 mmHg (<12 mmHg), 3 mmHg (12‐16 mmHg) or 4 mmHg (>16 mmHg) depending on the baseline IOP . Results Patient age was 79.3 ± 7.6 years (mean ± SD ) and gender distribution 15 males and 32 females. The mean pre‐ SLT IOP was 15.6 ± 5.1 (range 9–28) mmHg, and mean number of glaucoma drugs 2.0 ± 1.2. The mean interval between prior ALT and SLT was 44.0 ± 36.9 (range 11–137) months. After SLT , the mean IOP change was −2.7 ± 4.2 mmHg (−14.8 ± 23.5%) at 3 months, and −2.8 ± 3.5 mmHg (−16.3 ± 19.4%) at 9 months. Pre‐ SLT IOP correlated with the IOP reduction at 3 months ( r = 0.530, p < 0.001) and at 9 months ( r = 0.432, p = 0.007). The overall success rate was 50% at 3 months, and 42% at 9 months. At both 3 and at 9 months, the cut‐off level for treatment success was achieved when preoperative IOP was 18 mmHg and above. IOP lowering effect of SLT did not correlate with the number of glaucoma drugs, age, gender or use of prostaglandin inhibitors. Neither postoperative iritis nor other adverse effects were documented during the follow‐up. Conclusions Selective laser trabeculoplasty is a safe and noteworthy treatment option to reduce IOP in exfoliative glaucoma eyes, especially with pre‐ SLT IOP over 18 mmHg.