Selective Laser Trabeculoplasty after a Previous Glaucoma Treatment

Abstract

Background/Objectives: Recent prospective studies have shown that selective laser tra-beculoplasty (SLT) is a safe and cost-effective alternative to pressure-reducing eye drop therapy as a first-line treatment for ocular hypertension or open-angle glaucoma. In addition to its comparable efficacy to eye drop therapy, SLT has been particularly effective in delaying the time until a surgical intervention is needed. The aim of our evaluation is to analyze patients who have received SLT following a pressure-reducing procedure. The primary endpoint is the duration until a subsequent interventional or surgical procedure is required. Methods: A retrospective analysis of 98 patients who underwent selective laser trabeculoplasty following a previous pressure-reducing procedure between 2017 and 2023. The statistical analyses included Cox regression and Kaplan–Meier survival estimations. Results: In total, 122 eyes of 98 patients received selective laser trabeculoplasty following a previous pressure-reducing procedure at the Department of Ophthalmology in Freiburg. The median follow-up period was 381.5 days (range 43.25–862.75 days). Approximately 68% of the eyes did not require another pressure-reducing procedure 365 days after the intervention, while about 58% of the eyes remained without another procedure after 730 days, according to Kaplan–Meier analysis. No significant difference was found between the different types of glaucoma regarding the duration until a subsequent pressure-reducing procedure was needed. The study indicated a tendency for patients with pseudoexfoliation glaucoma to undergo a secondary intervention earlier compared to those with primary open-angle glaucoma (p = 0.16). The intraocular pressure before SLT had a significant impact on the duration until the subsequent operation (p = 0.005). Conclusions: SLT is an effective method even after a previous pressure-reducing procedure for patients in whom further pressure-reducing interventions need to be delayed.

Keywords

• glaucoma
• selective laser trabeculoplasty
• pressure-reducing procedure
• open-angle glaucoma