Selective laser trabeculoplasty for early glaucoma: analysis of success predictors and adjusted laser outcomes based on the untreated fellow eye

Selective laser trabeculoplasty for early glaucoma: analysis of success predictors and adjusted laser outcomes based on the untreated fellow eye

Author Chun, Mikael Autor UNIFESP Google Scholar
Gracitelli, Carolina Pelegrini Barbosa Autor UNIFESP Google Scholar
Lopes, Flavio Siqueira Santos Autor UNIFESP Google Scholar
Biteli, Luis Gustavo Autor UNIFESP Google Scholar
Ushida, Michele Google Scholar
Prata, Tiago dos Santos Autor UNIFESP Google Scholar
Abstract Background: To identify success predictors and to study the role of the fellow untreated eye as a co-variable for adjustment of intraocular pressure (IOP) outcomes following selective laser trabeculoplasty (SLT) in early open-angle glaucoma (OAG) patients. Methods: A case series was carried out. Patients with uncontrolled early OAG or ocular hypertension (inadequate IOP control requiring additional treatment) underwent SLT (one single laser session) performed by the same surgeon in a standardized fashion. The same preoperative medical regimen was maintained during follow-up for all patients. Post-treatment assessments were scheduled at week 1 and months 1, 2, and 3. In order to account for possible influence of IOP fluctuation on laser outcomes, post-laser IOP values of the treated eye of each patient were also analyzed adjusting for IOP changes (between visits variation) of the untreated fellow eye (adjusted analysis). Pre and post-laser IOP values were compared using paired t-test. Factors associated with the magnitude of IOP reduction were investigated using multiple regression analysis. Results: A total of 45 eyes of 45 patients were enrolled. Mean IOP was reduced from 20.8 +/- 5.1 to 14.9 +/- 2. 9 mmHg at month 3 (p < 0.001). Adjusted success rate (defined as IOP reduction >= 20%) was 64% and mean percentage of IOP reduction was 23.1 +/- 14.3% at last follow-up visit. Considering unadjusted post-laser IOP values, it was found a 20% greater absolute IOP reduction (median [interquartile range] 6 mmHg [4-7] vs 5 mmHg [3-7]

p = 0.04), with a success rate of 76%. Although baseline IOP was significantly associated with both adjusted and unadjusted post-laser IOP reduction, a stronger association was found when unadjusted IOP values were considered (p < 0.001 and R-2 = 0.35

p < 0.001 and R-2 = 0.67, respectively). Age, mean deviation (MD) index, central corneal thickness and type of glaucoma were not significant predictors (p >= 0.150). Conclusions: In this group of patients with early OAG or ocular hypertension, our short-term results confirmed SLT as a safe and effective alternative for IOP reduction. Although better outcomes were found in eyes with higher preoperative IOP, this effect was mitigated when results were adjusted to the fellow untreated eye (to the influence of between visits-IOP fluctuations).
Keywords Selective laser trabeculoplasty
Intraocular pressure
Fellow eye
Open-angle glaucoma
Treatment
xmlui.dri2xhtml.METS-1.0.item-coverage London
Language English
Date 2016
Published in Bmc Ophthalmology. London, v. 16, p. -, 2016.
ISSN 1471-2415 (Sherpa/Romeo, impact factor)
Publisher Biomed Central Ltd
Extent -
Origin http://dx.doi.org/10.1186/s12886-016-0385-z
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000388514200001
URI https://repositorio.unifesp.br/handle/11600/56704

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