Selective laser trabeculoplasty in patients with angle recession glaucoma: A small case series

Background. To investigate the efficacy of selective laser trabeculoplasty (SLT) for lowering intraocular pressure (IOP) in patients with open angle glaucoma (OAG) secondary to emulsified silicone oil (SO).Methodology/Principal Findings. Prospective, interventional, consecutive case series of 11 eyes with sustained elevation of IOP after SO removal. The mean IOP at baseline, week 1, month 1, month 3, and month 6 was evaluated. The mean baseline IOP was significantly decreased from 25 ± 2.7 mmHg to 18.4 ± 5.5 mmHg at week 1(P=0.01), 17.9 ± 3.1 mmHg at month 1(P=0.008), 15.8 ± 3.9 mmHg at month 3(P=0.003), and 16.2 ± 4.7 mmHg at month 6(P=0.004). IOP < 21 mmHg was achieved in 91% of the eyes without a significant complication at month 6.Conclusion/Significance. SLT may be successful for lowering IOP in patients with OAG secondary to emulsified SO which was not controlled with maximum antiglaucomatous medical treatment.

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Real-World Data from Selective Laser Trabeculoplasty in Brazil

10.21203/rs.3.rs-579451/v1 ◽

2021 ◽

Author(s):

Ricardo Y. Abe ◽

Heloísa A. Maestrini ◽

Guilherme B. Guedes ◽

Marcelo M. Nascimento ◽

Camila I. Iguma ◽

...

Keyword(s):

Real World ◽

Treatment Success ◽

Case Series ◽

Mean Deviation ◽

Selective Laser Trabeculoplasty ◽

Real World Data ◽

Retrospective Case ◽

World Data ◽

Laser Trabeculoplasty ◽

The Mean

Abstract Purpose: Evaluate real-world data of outcomes from selective laser trabeculoplasty (SLT) performed in different regions of Brazil and also investigate potential predictors of success associated with treatment.Methods: Multicenter retrospective case series with patients who underwent a primary SLT procedure. Results: A total of 835 eyes from 835 patients were included. The mean follow-up was 916.8 ± 563.0 days. The mean age was 64.5 ± 14.9 years and 56.6% were women. We observed a intraocular pressure reduction comparing baseline to post-SLT measurements (18.4 ± 3.8mmHg versus 14.8 ± 3.5mmHg; P<0.001) and mean number of glaucoma medications (1.8 ± 1.3 versus 1.4 ± 1.4; P<0.001). We observed visual acuity loss over time (0.1 ± 0.3 versus 0.2 ± 0.3 logMAR, baseline and post-SLT, respectively, P=0.009) and decrease in visual field mean deviation values (-5.4 ± 5.9 versus -5.7 ± 6.0dB; P=0.054) The Kaplan-Meier survival analysis showed an estimated probability of treatment success of 88% at 12 months, declining to 70% at 24 months and 54% at 36 months post-SLT. In the multivariable model, we found that a denser angle pigmentation (HR 0.69; 95% CI: 0.57 – 0.85, P=0.001) and corticosteroid treatment following SLT (HR 0.59; 95% CI: 0.39 – 0.91, P=0.018) were significantly associated with a lower risk for failure. Conclusions: Primary SLT achieved relatively high success rates without sight-threating complications in this real-world study with a large sample of Brazilian patients. These findings corroborate previous studies regarding SLT outcomes and may help clinicians to identify the best candidates for laser treatment.

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Clinical outcomes following selective laser trabeculoplasty in Afro-Caribbean patients with glaucoma at high risk for progression

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-317117 ◽

2021 ◽

pp. bjophthalmol-2020-317117

Author(s):

Tony Realini ◽

Hazel Shillingford-Ricketts ◽

Darra Burt ◽

Goundappa K Balasubramani

Keyword(s):

High Risk ◽

Clinical Outcomes ◽

Open Angle Glaucoma ◽

Medication Use ◽

Case Series ◽

Patient Specific ◽

Selective Laser Trabeculoplasty ◽

Time Points ◽

Laser Trabeculoplasty

AimTo characterise clinical outcomes following selective laser trabeculoplasty (SLT) in eyes of Afro-Caribbean patients with open-angle glaucoma (OAG) at high risk for progression.MethodsIn a prospective interventional case series, patients meeting high-risk criteria (advanced disease, unilateral glaucoma blindness, inadequate intraocular pressure (IOP) on >2 medications, recent progression on medications, inability to administer, afford or tolerate medications) underwent bilateral 360° SLT and managed based on their subsequent clinical course. Patient-specific indications for SLT—IOP reduction (IOP group) or reduced reliance on medical therapy (MED group)—were recorded before treatment. IOP and medication use were recorded every 3–4 months through up to 24 months of follow-up. Outcomes were analysed separately in the IOP and MED groups.ResultsAmong 33 right eyes (left eye outcomes were similar) in the IOP group, mean (SD) IOP was significantly reduced from 21.7 (7.5) mm Hg to 16.2–17.1 mm Hg over follow-up (p<0.0177); medication use remained unchanged (p>0.05) at all time points. Among 36 right eyes in the MED group, mean medication use was 1.9 (0.9) at baseline and ranged from 1.2 to 1.4 medications per eye through follow-up (p<0.0033), and mean IOP was significantly reduced at months 1–6 (to 13.1 (2.3) mm Hg, p=0.0013), months 13–18 (to 14.3 (2.8), p=0.0136) and unchanged at other time points. No vision-threatening adverse events occurred.ConclusionsAfro-Caribbean patients with OAG at risk for progression can achieve clinically and statistically significant reductions in IOP or medications through up to 24 months following a single 360° SLT treatment.Trial registration numberNCT02375009.

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