Selective laser trabeculoplasty in the treatment of open-angle glaucoma.

PURPOSE: To determine the effect of selective laser trabeculoplasty (SLT) on different types of open-angle glaucoma (OAG) in terms of intraocular pressure (IOP). METHODS AND MATERIALS: In this prospective, nonrandomized, interventional study, patients with OAG, unresponsive to maximum tolerable antiglaucoma medication, were enrolled. One thirty six eyes were studied. Distribution of glaucoma type was 91 primary OAG eyes (POAG, 66.9%), 22 pseudoexfoliative glaucoma (PEX, 16.2%) eyes, and 23 pigmentary glaucoma (PG, 16.9%) eyes. Main outcome measures were IOP and number of antiglaucoma medications used before operation, at 1 day, at 1 week, and at 1 to 18 months after surgery. Using the standard approach 360-degree SLT was done.
RESULTS: The mean follow-up was 16.6±4.3 months. The mean preoperative IOP was 22.0±3.7 mm Hg, and reduced to 18.3±3.7 mm Hg at last visit. The overall mean IOP decrease was 3.6±2.6 mm Hg (16.3%) on the last visit compared with before surgery, indicating a reduction of 16.7% in POAG, 16.6% in PEX, and 14.5% in PG. Comparison of IOP values at 6 and 16 months showed an increase of 0.5 and 2.7 mm Hg in total sample and PG group. IOP reduction was significantly less among diabetic patients.
CONCLUSIONS: SLT resulted in a significant IOP reduction of 16.3% at 16 months after surgery. The level of IOP reduction did not vary in POAG, PEX, and PG groups. A significant increase in IOP was observed in PG group after 6 months. The procedure seemed least effective in diabetic patients.