Long-Term Efficacy of Selective Laser Trabeculoplasty in Patients on Prostaglandin Therapy

Abstract

Background: The aim of the study was to analyse the efficacy of selective laser trabeculoplasty in patients on medical therapy and to evaluate a possible influence of prostaglandin therapy on intraocular pressure reduction. Patients and Methods: A retrospective chart review was undertaken of patients with ocular hypertension or open angle glaucoma who underwent selective laser trabeculoplasty between 3/2008 and 12/2010. Data were collected preoperatively, on the day of intervention, 1 day, 1 month and then every 3 months post selective laser trabeculoplasty. The main outcome measure was mean intraocular pressure reduction. Results: 109 eyes (76 on prostaglandins) were included. Mean preoperative intraocular pressure was 22.3 ± 4.5 mmHg (prostaglandin naïve) and 19.2 ± 4.8 mmHg (on prostaglandin) (p = 0.003). Up to 1 year follow-up, intraocular pressure was statistically significantly reduced in both groups (p ≤ 0.019). Eyes with a higher preoperative intraocular pressure had a greater pressure reduction (Spearman rho = 0.387, p = 0.002). Eyes naïve to prostaglandins initially had a greater reduction in intraocular pressure, although after 1 year of follow-up the difference was no longer statistically significant. Conclusions: Selective laser trabeculoplasty significantly reduces intraocular pressure in patients already on medical therapy. A sustained influence of prostaglandin therapy on the efficacy of selective laser trabeculoplasty was not found.

Zusammenfassung

Hintergrund: Ziel der Studie war, die augendrucksenkende Wirkung der selektiven Lasertrabekuloplastik bei Patienten unter Therapie sowie einen möglichen Einfluss von Prostaglandin-Therapie auf die Drucksenkung zu untersuchen. Patienten und Methoden: Retrospektive Kohortenstudie von Patienten mit okulärer Hypertension oder Offenwinkelglaukom, die von 3/2008 bis 12/2010 eine selektive Lasertrabekuloplastik hatten. Augendruckwerte vor, am Tag der selektiven Lasertrabekuloplastik, einen Monat und dann 3-monatlich nach Laserbehandlung wurden ausgewertet. Hauptergebnis war die mittlere Augendrucksenkung. Ergebnisse: 109 Augen (76 mit Prostaglandin-Therapie) wurden inkludiert. Der mittlere präoperative Augendruck war 22.3 ± 4.5 mmHg (ohne Prostaglandine) und 19.2 ± 4.8 mmHg (mit Prostaglandinen) (p = 0,003). Bis zu einem Jahr war der Augendruck in beiden Gruppen signifikant reduziert (p ≤ 0,019). Augen mit höherem präoperativen Augendruck hatten eine stärkere Drucksenkung (Spearman rho = 0,387, p = 0,002). Augen ohne Prostaglandin-Therapie hatten initial eine stärkere Drucksenkung als Augen mit Prostaglandin-Therapie; der Unterschied war nach einem Jahr nicht mehr signifikant. Schlussfolgerungen: Selektive Lasertrabekuloplastik reduziert bei Patienten unter Therapie den Augendruck signifikant. Ein dauerhafter Effekt von Prostaglandin-Therapie auf die Drucksenkung wurde nicht gefunden.

Key words

open angle glaucoma - ocular hypertension - selective laser trabeculoplasty - intraocular pressure

Schlüsselwörter

Offenwinkelglaukom - okuläre Hypertension - selektive Lasertrabekuloplastik - Augendruck

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