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Intraocular pressure‐lowering medications and long‐term outcomes of selective laser trabeculoplasty
Author(s) -
Woo David M,
Healey Paul R,
Graham Stuart L,
Goldberg Ivan
Publication year - 2014
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/ceo.12452
Subject(s) - medicine , intraocular pressure , term (time) , optometry , ophthalmology , glaucoma , quantum mechanics , physics
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 S ydney, A ustralia. 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 ( E llex) 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 used none ( 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 20.4 mmHg, respectively ( P = 0.061). Post‐treatment mean intraocular pressure was 17.9, 17.7, 15.5, and 15.7 mmHg; percentage reduction was similar between groups (23.6–25.6%, P = 0.20). K aplan– M eier 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.