Real-world data from selective laser trabeculoplasty in Brazil

Abstract

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.

A Review of Selective Laser Trabeculoplasty: “The Hype Is Real”

“…The following study by Abe et al [84] revolved around similar endpoints and reported significantly better results regarding SLT efficiency. SLT was studied for three common indications: uncontrolled IOP without medications, uncontrolled IOP with medications, and controlled IOP with medications for the purpose of reducing the number of hypotensive medications.…”

“…Hirabayashi et al [113] stated that baseline IOP of >18 mmHg was significantly associated with increased success and that the IOP-lowering effect was greatest at 2 months and 6 months of follow-up. The effect of higher baseline IOP on success was confirmed in the real-world retrospective studies [83,84]. Khawaja et al found that factors, such as glaucoma type or grade, TM pigmentation, or the type of topical medication, did not seem to predict SLT success.…”

Prevalence, Clinical Characteristics and Determinants of Unsuccessful Treatment Outcomes Among Pulmonary Tuberculosis Patients: A 5-Year Registry-Based Retrospective Cohort Study

“…This study not only evaluated treatment outcomes in new smear-positive PTB patients but also identified risk factors associated with unsuccessful treatment outcomes. Over 2/3rd of patients (88.5%) of patients have successful treatment outcomes, which is higher than treatment success rate in India (74%), 17 Brazil (71%) 18 and Pakistan (69%). 19 The successful treatment outcomes recorded in our study could be attributed to the introduction of effective policies by the NTP and WHO for the eradication of TB in Saudi Arabia.…”

Selective Laser Trabeculoplasty

“…Higher starting IOP was correlated with success whereas patient age, concurrent use of IOP drops, and baseline visual field mean deviation had no correlation with outcomes. Another retrospective study conducted in Brazil by Abe et al, 57 with similar failure criteria reported failure of SLT at 3 years at 54%. Among patients who had medically controlled IOP before SLT, success was 49% at 36 months with 37% remaining off any drops.…”

“…A higher starting baseline IOP has been found by several studies to correlate with greater IOP reduction after SLT. 16,32,33,[56][57][58] The association of SLT success with other factors, such as age, glaucoma severity, type of glaucoma, TM pigmentation, or type of postprocedure eye drop regimen, is less definitive as conflicting results have been reported. 32,33,56,57…”