Predictive factors of success in selective laser trabeculoplasty (SLT) treatment

Abstract

Purpose:Glaucoma is a progressive optic neuropathy that may lead to blindness. Reducing intraocular pressure (IOP) is the only known treatment to slow progression in glaucoma. IOP can be reduced by pharmaceutical treatment, laser and surgery. The aim of the present study was to assess predictive factors of success after selective laser trabeculoplasty (SLT) treatment.Methods:We used a retrospective chart review of eyes that underwent SLT between January 1, 2005 and December 31, 2005. The dependent variable was time to failure after SLT treatment. Failure after SLT was defined as any changes in the medical treatment, and/or a new SLT treatment was performed and/or the patient was sent for surgery. All patients were treated with 90° SLT. A multivariate regression analysis was performed to assess correlation between time to failure after SLT and age, gender, IOP before treatment, number of medications used, SLT number, amount of spots, laser energy used, grade of angle, pigmentation and diagnosis.Results:120 eyes of 120 patients were identified. The average time to failure after SLT was 18 months. The predictive factors identified were: age, IOP before SLT and dose.Conclusion:Predictive factors identified in our study were high baseline IOP, age and amount of laser energy used. Our study confirms previous results about baseline IOP as a predictive factor.

Repeat selective laser trabeculoplasty can be effective in eyes with initial modest response

“…In our study, mean IOP was lower at each follow-up time compared to baseline in both SLT1 and SLT2, indicating its efficacy 111213. Similar to other studies, our findings in SLT1 confirm that higher baseline IOP is a significant predictor of IOP reduction ≥20% from baseline 141516. A higher baseline IOP however did not predict IOP reduction upon SLT2.…”

Optimal Selective Laser Trabeculoplasty Energy for Maximal Intraocular Pressure Reduction in Open-Angle Glaucoma

“…First, the sample size of the current study is not large comparing to previous retrospective analyses (eg, 120 eyes in the study by Ayala et al 10 ). Second, the baseline IOP was varied among the recruited subjects, likely due to the inclusion of NTG patients.…”

“…7 Although a higher prelaser IOP is a consistent predictor for SLT success, 8,9 laser energy was also found to be one of the factors that positively correlate with time to failure in a retrospective predictive analysis. 10 Success rate of SLT treatment of 360 degrees of the trabecular meshwork was also found to be comparable with latanoprost 0.005%, but not in the groups receiving 90 or 180 degrees in a randomized controlled trial. However, the total energy in terms of the number of spots and energy per spot used in each group was not compared.…”

Selective Trabeculoplasty in the Management of Open Angle Glaucoma: Retrospective Analysis at 1 Year

“…In the literature, other factors seem to have an impact on the efficacy of selective trabeculoplasty, but were not observed in our study due to its lack of statistical power for measures of pre-laser IOP [23][24][25][26][27], age [27], use of a prostaglandin before SLT (which may be a factor for lower efficacy) [26] or treatment energy levels [27,28]. Lee, et al has also evaluated optimal total treatment energy, at 226.1 mJ [29].…”