Selective laser trabeculoplasty in pseudophakic and phakic eyes: a prospective study

To compare the efficacy of selective laser trabeculoplasty (SLT) in replacing medical therapy in pseudophakic and phakic eyes.

Subgroup of a prospective randomized clinical trial including patients with primary open angle glaucoma or ocular hypertension controlled with medication. Of 38 pseudophakic eyes were matched with 38 phakic eyes. SLT was offered as a way to decrease medication while maintaining the same low eye pressure. SLT was performed over 360°, at 3ns, spotsize 400 µm, 100 spots. Data [intraocular pressure (IOP), number of medications needed] were measured at 1h, 1wk, 1, 3, 6 and 12mo. An independent-samples t-test was performed to compare baseline characteristics of the phakic and the pseudophakic group and differences in evolution of mean IOP and number of used medications. Chi-squared analysis was performed to investigate proportions of fast, slow and non-responders.

The mean IOP measurement was 13.00± 2.88 mm Hg in the phakic group (38 eyes) and 13.51±3.06 mm Hg in the pseudophakic group (38 eyes) (P>0.05). This changed little after SLT and IOP lowering effect was comparable between the two groups. Main aim however was to lower the amount of medication needed. In the phakic group medication lowered from 1.29±0.62 at baseline, to 0.15±0.46 after 12mo; a reduction of 88.37%. In the pseudophakic group, used medication changed from 1.71±1.04, to 0.41±0.61; a 76.02% reduction. The differences were not statistically significant at any time point (P>0.05). IOP lowering occurred slightly faster in the pseudophakic group (50% of patients after one week) than in the phakic group (68% of patients after more than 4wk). The difference was not significant (P>0.05).

IOP lowering effect of SLT is comparable between phakic and pseudophakic eyes.