Effectiveness of selective laser trabeculoplasty in glaucoma patients: a 6 years follow up study

Abstract

AbstractThe use of laser trabeculoplasty (SLT) to lower intraocular pressure (IOP) has provided an alternative strategy to treat open angle glaucoma (OAG) or ocular hypertension (OHT). SLT lowers IOP by enhancing aqueous humor outflow through the trabecular meshwork. It induces less coagulative damage than argon laser trabeculoplasty. The effect of SLT diminishes over time and some patients may need more treatment or surgery.PurposeTo evaluate long‐term effectiveness of SLT in OAG/OHT.MethodsRetrospective cohort study. All patients with OAG/OHT treated in 2012 with 180º SLT were included. Patients with <1 year of follow up were excluded. Following SLT, patients were examined at 6, 12, 24, 36, 48, 60 and 72 months. In each visit IOP was measured, and fundus and anterior segment were examined. Structural images and visual fields were performed to asses glaucoma progression.ResultsSeventy‐eight eyes of 49 patients were included. Mean age was 65.2 ± 12.2 years old. Forty two eyes had OAG, 6 pseudo‐exfoliation glaucoma, two pigmentary glaucoma, two aphakic glaucoma and 26 had OHT. The mean follow‐up was 5.2 ± 1.4 years. Mean previous IOP was 21.2 ± 3.7 mmHg. After treatment, and excluding patients who required surgery, IOP had significantly decreased to 17.1 ± 3.2 mmHg at one year (n = 73; p < 0.001) and to 17.4 ± 3.5 mmHg (p < 0.001) at 6 years of follow‐up (n = 41). The number of drugs used was 2 ± 1.1 before treatment and 1.9 ± 1.2 (n = 41; p = 0.55) after 6 years. A total of 35 eyes (27.3%) needed more than one SLT session to achieve the desired IOP and 18 eyes (23.1%) needed glaucoma surgery in a mean time of 2 years after the first SLT. None of the patients had major complications related to SLT treatment.ConclusionAlthough the effect of SLT decreases with time, our study shows that it can be an effective technique to significantly lower IOP after 6 years of follow up.