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Purpose-To evaluate the efficacy of repeat 360° selective laser trabeculoplasty (SLT) in glaucoma patients with prior successful 360° SLT. Design-Retrospective chart reviewMethods-Forty-four eyes of 35 patients, ≥ 18 years of age, with open-angle glaucoma (primary open-angle, pseudoexfoliation or pigmentary glaucoma), uncontrolled on maximum tolerable medical therapy, underwent an initial 360° SLT (SLT1), which was successful for ≥ 6 months, but eventually lost efficacy and was followed by a repeat 360° SLT (SLT2). Patients with prior argon laser trabeculoplasty or other glaucoma surgery, before or during the study period, were excluded. Intraocular pressure (IOP) measurements were recorded before each procedure and 1-4 weeks, 1-3 months, and 5-8 months post-treatment, as well 15-21 weeks after the initial SLT.Results-Reduction in IOP after SLT1 and SLT2 was significantly less with repeat treatment at 1-3 months, with average decreases of −5.0 and −2.9mmHg, respectively (p=.01); but there were no statistically significant differences between treatments at the other equivalent time points. Using a definition of "success" as ≥ 20% peak IOP reduction, success rates for SLT1 and SLT2 were not significantly different. There was also no significant difference in eyes that received SLT2 6-12 months after SLT1 compared to those that received SLT2 12 months or more after SLT1.Conclusions-Our findings suggest that repeat 360° SLT may be safe and effective after an initially successful 360° SLT has failed. These results may be achieved as early as six months after the first treatment.

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