Predictive Factors for Outcomes of Selective Laser Trabeculoplasty

Hirabayashi, Matthew; Ponnusamy, Vikram; An, Jella

doi:10.1038/s41598-020-66473-0

Cited by 19 publications

(17 citation statements)

References 35 publications

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“…The investigation of predictors of success for SLT is important to guide the clinician into obtaining better outcomes and to provide patients with information regarding risks of failure and procedure outcomes. Despite previous studies have described baseline IOP as predictor of success, in our univariable and multivariable analyses, baseline IOP did not achieve statistical significance 14 , 29 . We found that patients with less advanced functional damage had better chances of obtaining success after SLT in the univariable analysis.…”

Section: Discussioncontrasting

confidence: 99%

Real-world data from selective laser trabeculoplasty in Brazil

Abe

Maestrini²,

Guedes³

et al. 2022

Sci Rep

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Evaluate real-world data of outcomes from selective laser trabeculoplasty (SLT) performed in different regions of Brazil and investigate potential predictors of success associated with treatment. Multicenter retrospective case series with patients who underwent a primary SLT procedure. A total of 835 eyes from 835 patients were included. The mean follow-up was 916.8 ± 563.0 days. The mean age was 64.5 ± 14.9 years and 56.6% were women. We observed an intraocular pressure reduction comparing baseline to post-SLT measurements (18.4 ± 3.8 mmHg versus 14.8 ± 3.5 mmHg; P < 0.001) and mean number of glaucoma medications (1.8 ± 1.3 versus 1.4 ± 1.4; P < 0.001). We observed visual acuity loss over time (0.1 ± 0.3 versus 0.2 ± 0.3 logMAR, baseline and post-SLT, respectively, P = 0.009) and decrease in visual field mean deviation values (− 5.4 ± 5.9 versus − 5.7 ± 6.0 dB; P = 0.054) The Kaplan–Meier survival analysis showed an estimated probability of treatment success of 88% at 12 months, declining to 70% at 24 months and 54% at 36 months post-SLT. In the multivariable model, we found that a denser angle pigmentation (HR 0.69; 95% CI 0.57–0.85, P = 0.001) and corticosteroid treatment following SLT (HR 0.59; 95% CI 0.39–0.91, P = 0.018) were significantly associated with a lower risk for failure. Primary SLT achieved relatively high success rates without sight-threating complications in this real-world study with a large sample of Brazilian patients. These findings corroborate previous studies regarding SLT outcomes and may help clinicians to identify the best candidates for laser treatment.

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Section: Discussioncontrasting

confidence: 99%

Real-world data from selective laser trabeculoplasty in Brazil

Abe

Maestrini²,

Guedes³

et al. 2022

Sci Rep

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“…With 72 patients evaluated at their one-year follow-up, Hodge et al demonstrated that SLT success was strongly predicted by baseline IOP (odds ratio = 1.16; p = 0.0001) and not by age, sex, glaucoma type or grade of TM pigmentation [ 62 ]. Similar results were shown in a recent retrospective review by Hirabayashi et al [ 63 ]. In this study, at 6 months, patients with a baseline IOP > 18 mmHg showed an IOP reduction of 5.4 ± 5.3 mmHg (23.7% reduction), whereas patients with a baseline IOP < 18 mmHg showed a reduction of −0.7 ± 4.6 mmHg (4.9% increase; p < 0.001).…”

Section: Predictive Factorssupporting

confidence: 91%

“…These results are consistent with three other trials. The results of a post hoc analysis of the LIGHT study by Garg et al (mentioned above in the subsection “SLT as first-line therapy”) showed that early absolute IOP reduction was positively correlated with baseline IOP and negatively correlated with female gender [ 13 , 14 , 31 , 62 , 63 , 64 , 65 , 66 ].…”

Section: Predictive Factorsmentioning

confidence: 99%

Selective Laser Trabeculoplasty in the Treatment of Ocular Hypertension and Open-Angle Glaucoma: Clinical Review

Zgryźniak

Przeździecka-Dołyk

Szaliński

et al. 2021

JCM

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Selective laser trabeculoplasty (SLT) is a glaucoma treatment that reduces intraocular pressure (IOP). Its mechanism is based on the biological effects of the selective application of laser energy to pigmented trabecular meshwork (TM) cells, resulting in increased outflow facility. Herein, we review current publications on SLT and summarize its efficacy and safety for different indications in open-angle glaucoma (OAG) and ocular hypertension (OHT) treatment. SLT effectively reduces IOP when used as a primary treatment. In patients whose IOP is medically controlled, SLT helps to reduce medication use, and when maximally tolerated topical therapy is ineffective, SLT facilitates the realization of the target IOP. SLT is a repeatable procedure for which the vast majority of complications are mild and self-limiting. With effective IOP reduction, low complication rates and the potential to repeat the procedure, SLT offers the possibility of delaying the introduction of medical therapy and other more invasive treatment modalities while simultaneously avoiding the accompanying complications. With this knowledge, we suggest that SLT be considered as an essential primary treatment option in OAG and OHT, switching to other treatment modalities only when laser procedures are insufficient for achieving the required target IOP.

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“…Despite previous studies have described baseline IOP as predictor of success, in our univariable and multivariable analyses, baseline IOP did not achieve statistical signi cance. 14,29 We found that patients with less advanced functional damage had better chances of obtaining success after SLT in the univariable analysis. This nding reinforces the concept that SLT is a good option for initial treatment, especially for those with mild glaucoma comparing to patients with moderate and advanced glaucoma that might require a lower target pressure.…”

Section: Resultsmentioning

confidence: 78%

Real-World Data from Selective Laser Trabeculoplasty in Brazil

Abe

Maestrini²,

Guedes³

et al. 2021

Preprint

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Purpose: Evaluate real-world data of outcomes from selective laser trabeculoplasty (SLT) performed in different regions of Brazil and also investigate potential predictors of success associated with treatment.Methods: Multicenter retrospective case series with patients who underwent a primary SLT procedure. Results: A total of 835 eyes from 835 patients were included. The mean follow-up was 916.8 ± 563.0 days. The mean age was 64.5 ± 14.9 years and 56.6% were women. We observed a intraocular pressure reduction comparing baseline to post-SLT measurements (18.4 ± 3.8mmHg versus 14.8 ± 3.5mmHg; P<0.001) and mean number of glaucoma medications (1.8 ± 1.3 versus 1.4 ± 1.4; P<0.001). We observed visual acuity loss over time (0.1 ± 0.3 versus 0.2 ± 0.3 logMAR, baseline and post-SLT, respectively, P=0.009) and decrease in visual field mean deviation values (-5.4 ± 5.9 versus -5.7 ± 6.0dB; P=0.054) The Kaplan-Meier survival analysis showed an estimated probability of treatment success of 88% at 12 months, declining to 70% at 24 months and 54% at 36 months post-SLT. In the multivariable model, we found that a denser angle pigmentation (HR 0.69; 95% CI: 0.57 – 0.85, P=0.001) and corticosteroid treatment following SLT (HR 0.59; 95% CI: 0.39 – 0.91, P=0.018) were significantly associated with a lower risk for failure. Conclusions: Primary SLT achieved relatively high success rates without sight-threating complications in this real-world study with a large sample of Brazilian patients. These findings corroborate previous studies regarding SLT outcomes and may help clinicians to identify the best candidates for laser treatment.

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Predictive Factors for Outcomes of Selective Laser Trabeculoplasty

Cited by 19 publications

References 35 publications

Real-world data from selective laser trabeculoplasty in Brazil

Real-world data from selective laser trabeculoplasty in Brazil

Selective Laser Trabeculoplasty in the Treatment of Ocular Hypertension and Open-Angle Glaucoma: Clinical Review

Real-World Data from Selective Laser Trabeculoplasty in Brazil

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