Selective laser trabeculoplasty in primary open-angle glaucoma: Primary versus secondary treatment outcomes

Emil Goosen,Ben Sartorius,Linda Visser

doi:10.4102/aveh.v75i1.338

Abstract

Objective: To compare the outcomes of selective laser trabeculoplasty (SLT) on treatmentnaive, primary open-angle glaucoma (POAG) patients with those of SLT on patients previously treated medically and/or surgically. Secondary objectives: To establish whether age, race or gender influenced SLT outcomes.Design: A retrospective chart review of patients who received SLT therapy for POAG between June 2011 and January 2015.Subjects: Group A: Treatment-naive patients (n = 15). Group B: Prior medical therapy and/or prior surgery (n = 69).Methods: Group A: Patients were treated with SLT therapy as first line, with medical treatment added as needed. Group B: Patients were treated with SLT therapy as additional therapy to medication and/or surgery. All patients were followed up for at least 1 year.Main outcome measures: A reduction in intraocular pressure (IOP) of at least 20% from baseline was considered significant.Results: The following percentage reduction in IOP was found in the different groups: Group A 50.7%, Group B 32.0%, Africans 52.2%, Indians 29.8% and Caucasians 28.87%.Conclusion: In our study patients, SLT achieved significant reductions in IOPs in treatmentnaive as well as previously surgically and medically treated eyes with POAG. Statistically significant higher reductions in IOP at 1 year after SLT was seen in treatment-naive eyes, patients older than 70 years when compared with younger patients, female patients (54%) when compared with male patients (30%) and in patients of African (52%) descent compared with Caucasians (30%).

Highlights

There is no simple answer to how to treat primary open-angle glaucoma (POAG)
This study was conducted to determine if there is a difference in the outcomes of selective laser trabeculoplasty (SLT) therapy in treatment-naive POAG patients compared with those who have had prior medical or surgical therapy
Could SLT therapy be considered a first-line therapy for POAG1,2,3,4 or should its main role be as a supportive treatment to medical and surgical therapy? What is the survival time of SLT treatment

Summary

Introduction

There is no simple answer to how to treat primary open-angle glaucoma (POAG). The only proven modality to slow down the disease progression is to lower the intraocular pressure (IOP). Various treatment options exist, ranging from medication to laser treatments and surgical intervention. This study was conducted to determine if there is a difference in the outcomes of selective laser trabeculoplasty (SLT) therapy in treatment-naive POAG patients compared with those who have had prior medical or surgical therapy. The study looked at the possible influence of age, ethnicity and gender on the outcomes of SLT. Could SLT therapy be considered a first-line therapy for POAG1,2,3,4 or should its main role be as a supportive treatment to medical and surgical therapy? What is the survival time of SLT treatment?5,6 Could SLT therapy be considered a first-line therapy for POAG1,2,3,4 or should its main role be as a supportive treatment to medical and surgical therapy? What is the survival time of SLT treatment?5,6

Methods

Results

Discussion

Conclusion