Impact of Short-Term Topical Steroid Therapy on Selective Laser Trabeculoplasty Efficacy.

Tomaž Gračner

doi:10.3390/jcm10184249

Abstract

Background: To evaluate whether short-term use of topical steroid therapy affected the efficacy of selective laser trabeculoplasty (SLT) for primary open-glaucoma (POAG). Methods: 25 eyes of 25 patients, who used a drop of dexamethasone 0.1% 4 times a day for 7 days as post-laser therapy, formed the Steroid SLT group and 24 eyes of 24 patients, where no topical steroids or nonsteroidal anti-inflammatory agents as post-laser therapy were used, formed the No-steroid SLT group. Success was defined as an intraocular pressure (IOP) lowering exceeding 20% of pretreatment IOP. Results: The mean follow-up time was 21.24 months for the Steroid SLT group and 20.25 months for the No-steroid SLT group (p = 0.990). No significant difference was found between the two groups for mean pretreatment IOP (22.20 mmHg vs. 22.33 mmHg), and for mean IOP reductions during whole follow-up period. At all follow-up visits, the mean IOP reductions were smaller in the Steroid SLT group than in the No-steroid SLT group. At all follow-up visits, the mean percent IOP reduction was smaller in the Steroid SLT group than in the No-steroid SLT group, and such a difference was significant at 12 months (25.4% vs. 29.6%, p = 0.047) and 24 months (25.3% vs. 29.7%, p = 0.024). According to the Kaplan–Meier survival analysis, the 24-month success rate was 84% in the Steroid SLT group and 79.2% in the No-steroid SLT group, with no differences between the groups (p = 0.675). Conclusion: Short-term use of topical steroid therapy had no impact on the efficacy of SLT for POAG.

Highlights

Short-term use of topical steroid therapy had no impact on the efficacy of selective laser trabeculoplasty (SLT) for POAG
Exclusion criterion included a history of previous ocular surgery within 6 months, any previous glaucoma surgery, eye trauma, glaucoma laser therapy or uveitis to the study eye and any other form of glaucoma aside from POAG, such as normal-pressure glaucoma (NTG), pseudoexfoliative glaucoma (PXFG), or ocular hypertension (OH)
Med. 2021, 10, 4249 patients, number of eyes, age, sex, vertical Cup/Disc ratio, mean deviation, number of hypotensive medications, best corrected visual acuity, trabecular meshwork pigmentation, and mean baseline intraocular pressure (IOP) of the Steroid SLT group and the No-steroid SLT group are listed in and 22.33 mmHg (SD 2.6) in the No-steroid SLT group (p = 0.856). The differences between those baseline characteristics were statistically not significant, except the difference between mean energy used for each spot (p < 0.001) and total energy used (p < 0.001), which were higher in the No-steroid SLT group

Summary

Introduction

Selective laser trabeculoplasty (SLT), used since 1998 when the first successful protocol was described, has become an established method for lowering the intraocular pressure (IOP) in the treatment of open-angle glaucoma (OAG) and ocular hypertension (OH) [1,2,3,4,5]. At all follow-up visits, the mean IOP reductions were smaller in the Steroid SLT group than in the No-steroid SLT group. At all follow-up visits, the mean percent IOP reduction was smaller in the Steroid SLT group than in the No-steroid SLT group, and such a difference was significant at 12 months (25.4% vs 29.6%, p = 0.047) and 24 months (25.3% vs 29.7%, p = 0.024)

Methods

Results

Conclusion