Abstract
Background Selective laser trabeculoplasty (SLT) is a safe and effective treatment modality for lowering intraocular pressure (IOP). Purpose To determine the efficacy and safety of SLT among Ethiopian patients with primary open-angle glaucoma (POAG), pseudoexfoliation glaucoma (PXG), and ocular hypertension (OHT). Method A prospective, nonrandomized interventional study was conducted at Menelik II Hospital, Ethiopia. Patients on antiglaucoma medication with uncontrolled IOP and those patients treated for the first time with 360 degrees of SLT were included. Success was defined as an IOP lowering of > 20% from baseline without repeat treatment. Result A total of 95 eyes of 61 patients with a diagnosis of OAG and OHT were enrolled. The diagnosis was POAG in 55 (57.9%) eyes, PXG in 22 (23.2%) eyes, and OHT in 18 (18.9%) eyes. Seventy (73.7%) eyes were on medications, and 25 (26.3%) eyes were treated with laser as primary therapy. The mean (SD) baseline IOP and medication were 24.3 ± 2.5 mmHg and 1.29 ± 1.01, respectively. The one-year mean (SD) IOP reduction was 6.7 ± 4.2 mmHg and medication reduction was 0.26 ± 1.34. The overall IOP reduction at 12 months was 27.6%, and the success rate was 60%. The mean IOP (SD) reduction for patients who were treated for the first time with laser and on antiglaucoma medication was 6.5 ± 3.1 mmHg and 6.8 ± 2.8 mmHg, respectively. Post-SLT, patients experienced transient ocular pain, brow ache, headache, and/or blurring of vision in 31.6%, anterior chamber reaction in 36.8%, and IOP spike ≥ 6 mmHg in 11.6%. Conclusion SLT is an effective and safe treatment modality for OHT, POAG, and PXG among Ethiopian patients either as a first-line treatment or as an adjunct to topical glaucoma treatment.
Highlights
Selective laser trabeculoplasty (SLT) is a safe and effective treatment modality for lowering intraocular pressure (IOP)
Seventy (73.7%) eyes were on medications, and 25 (26.3%) eyes were treated with laser as primary therapy. e mean (SD) baseline IOP and medication were 24.3 ± 2.5 mmHg and 1.29 ± 1.01, respectively. e one-year mean (SD) IOP reduction was 6.7 ± 4.2 mmHg and medication reduction was 0.26 ± 1.34. e overall IOP reduction at 12 months was 27.6%, and the success rate was 60%. e mean IOP (SD) reduction for patients who were treated for the first time with laser and on antiglaucoma medication was 6.5 ± 3.1 mmHg and 6.8 ± 2.8 mmHg, respectively
We evaluated the efficacy and safety of SLT in patients with ocular hypertension (OHT) as well as various types of open-angle glaucoma (OAG)
Summary
Selective laser trabeculoplasty (SLT) is a safe and effective treatment modality for lowering intraocular pressure (IOP). Laser trabeculoplasty (LTP) has the potential to decrease IOP in patients with or at risk for open-angle glaucoma (OAG) without systemic side effects and to minimize concerns about compliance with drop therapy (depending on whether adjunctive medication is needed to achieve the target IOP range) [2, 3]. Successful in lowering IOP, ALT has Journal of Ophthalmology several side effects, most notably elevated IOP (short- and long-term spikes) and inflammation It coagulates the trabecular meshwork (TM) tissue, resulting in peripheral anterior synechiae, and repeat treatment has been shown to be ineffective [5]. E preservation of the trabecular meshwork architecture and the demonstrated efficacy in lowering IOP in a variety of open-angle glaucomas make SLT a reasonable and safe alternative to argon laser trabeculoplasty.
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