Selective laser trabeculoplasty in treating post-trabeculectomy advanced primary open-angle glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Research
• Surgical Interventions

Background:

• Primary open-angle glaucoma (POAG) management often requires multiple interventions.
• Post-trabeculectomy medication may not achieve target intraocular pressure (IOP).
• Selective laser trabeculoplasty (SLT) is a potential treatment option for refractory glaucoma.

Purpose of the Study:

• To evaluate the safety and efficacy of SLT in POAG patients with uncontrolled IOP after trabeculectomy.
• To assess the impact of SLT on IOP and IOP fluctuations.
• To determine the success rate of SLT in this patient cohort.

Main Methods:

• Sixteen patients (18 eyes) with POAG and inadequate IOP control post-medication and surgery underwent 360° SLT.
• IOP, anterior chamber inflammation, and daytime/long-term IOP fluctuations were monitored pre- and post-SLT.
• Treatment success was defined as >20% IOP reduction at 6 and 9 months.

Main Results:

• Mean pre-SLT IOP was 21.3±3.4 mmHg, decreasing to 16.2±3.0 mmHg post-treatment.
• SLT achieved a success rate of 77.7% in reducing IOP.
• Daytime IOP fluctuations significantly decreased from 4.1±1.4 mmHg to 2.6±1.1 mmHg (P<0.05).

Conclusions:

• Selective laser trabeculoplasty is a safe and effective treatment for reducing IOP in POAG patients who have undergone trabeculectomy.
• SLT successfully lowers IOP and mitigates diurnal IOP variations in this challenging patient group.
• This study supports SLT as a valuable therapeutic option for refractory glaucoma.