Repeatability of selective laser trabeculoplasty

To determine the intraocular pressure (IOP)-lowering efficacy of repeat 360° selective laser trabeculoplasty (SLT) in patients with open-angle glaucoma having undergone prior successful 360° SLT.

A retrospective chart review of 38 eyes of 38 patients with open-angle glaucoma (primary, pseudoexfoliation or pigmentary glaucoma) uncontrolled on medical therapy who had undergone two successive 360° SLT treatments, in whom first SLT was deemed clinically successful through a minimum of 6 months follow-up and who were followed for a minimum of 30 days after second SLT. Mean IOP at each postoperative time point (1, 3, 6, 12, 18 and 24 months) was compared with baseline using paired t tests. IOP changes after initial and repeat SLT were evaluated separately.

Mean (SD) baseline IOP before initial SLT was 21.6 (4.8) mm Hg. Mean IOP following initial SLT was significantly below baseline through 24 months of follow-up, with mean IOP at months 1-24 ranging from 15.9 to 18.6 mm Hg. Mean baseline IOP before repeat SLT was 19.1 (3.9) mm Hg, with a significant reduction in IOP from baseline through 24 months follow-up with mean IOP ranging from 14.7 to 17.0 mm Hg. Kaplan-Meier survival analysis showed longer median survival time for repeat SLT compared with initial SLT. No safety issues were observed with repeat SLT.

Repeat SLT can restore IOP control in eyes with open-angle glaucoma that have previously undergone successful initial SLT. Repeat SLT achieves comparable absolute level of IOP control achieved by initial SLT.