Selective laser trabeculoplasty for early glaucoma: analysis of success predictors and adjusted laser outcomes based on the untreated fellow eye

• Autor(a) principal: Chun, Mikael [UNIFESP]
• Data de Publicação: 2016
• Outros Autores: Gracitelli, Carolina Pelegrini Barbosa [UNIFESP], Lopes, Flavio Siqueira Santos [UNIFESP], Biteli, Luis Gustavo [UNIFESP], Ushida, Michele, Prata, Tiago dos Santos [UNIFESP]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1186/s12886-016-0385-z; https://repositorio.unifesp.br/handle/11600/56704
• topic: Selective laser trabeculoplasty; Intraocular pressure; Fellow eye; Open-angle glaucoma; Treatment

Background: To identify success predictors and to study the role of the fellow untreated eye as a co-variable for adjustment of intraocular pressure (IOP) outcomes following selective laser trabeculoplasty (SLT) in early open-angle glaucoma (OAG) patients. Methods: A case series was carried out. Patients with uncontrolled early OAG or ocular hypertension (inadequate IOP control requiring additional treatment) underwent SLT (one single laser session) performed by the same surgeon in a standardized fashion. The same preoperative medical regimen was maintained during follow-up for all patients. Post-treatment assessments were scheduled at week 1 and months 1, 2, and 3. In order to account for possible influence of IOP fluctuation on laser outcomes, post-laser IOP values of the treated eye of each patient were also analyzed adjusting for IOP changes (between visits variation) of the untreated fellow eye (adjusted analysis). Pre and post-laser IOP values were compared using paired t-test. Factors associated with the magnitude of IOP reduction were investigated using multiple regression analysis. Results: A total of 45 eyes of 45 patients were enrolled. Mean IOP was reduced from 20.8 +/- 5.1 to 14.9 +/- 2. 9 mmHg at month 3 (p < 0.001). Adjusted success rate (defined as IOP reduction >= 20%) was 64% and mean percentage of IOP reduction was 23.1 +/- 14.3% at last follow-up visit. Considering unadjusted post-laser IOP values, it was found a 20% greater absolute IOP reduction (median [interquartile range] 6 mmHg [4-7] vs 5 mmHg [3-7]