Effect of topical loteprednol on intraocular pressure after selective laser trabeculoplasty for open-angle glaucoma

To determine whether there is a statistically significant difference in the decrease in intraocular pressure (IOP) after selective laser trabeculoplasty (SLT) between patients receiving a 5-7 days co-administration of loteprednol versus no loteprednol over the course of 1 year.

We conducted a retrospective chart review to evaluate use of loteprednol in patients aged 30-85 years undergoing SLT for open-angle glaucoma at our center over a 3-year period.

Three hundred and eighteen eyes from 313 patients who underwent a 360° SLT treatment between January 2008 and August 2011 were included in the analysis. Patients who received loteprednol showed a mean reduction of 2.5 (±SE 0.3) mmHg or 11.8% (±1.5%) in IOP versus a mean reduction of 3.2 (±0.6) mmHg or 14.9% (±2.5%) in those not treated with loteprednol. This difference showed a trend toward lower IOP without loteprednol, but this was not statistically significant (p = 0.29).

Postoperative use of loteprednol does not appear to significantly affect IOP in patients undergoing SLT. A randomized double-blinded study in a larger group of patients would be required to clarify this issue. Until such information is available, we recommend that individual clinical judgment be used regarding whether to use topical steroids in patients undergoing SLT.