Comparative study of the efficacy of selective laser trabeculoplasty as initial or adjunctive treatment for primary...

The aim of this study is to compare the efficacy of selective laser trabeculoplasty as initial or adjunctive treatment for primary open-angle glaucoma in a retrospective chart review.

28 eyes of 28 patients with newly diagnosed primary open-angle glaucoma, who formed the initial selective laser trabeculoplasty group, and 31 eyes of 31 patients suffering from medical uncontrolled primary open-angle glaucoma, who formed the adjunctive selective laser trabeculoplasty group, were treated with 180° selective laser trabeculoplasty. Patients were evaluated 1, 3, 6, 12, 18 and 24 months after treatment. Success was defined as an intraocular pressure lowering exceeding 20% of pretreatment intraocular pressure.

The mean follow-up time was 20.25 months (standard deviation = 8.1) for the initial selective laser trabeculoplasty group and 18.87 months (standard deviation = 8.8) for the adjunctive selective laser trabeculoplasty group (p = 0.538). No significant difference was found between the two groups for mean pretreatment intraocular pressure (21.43 mmHg (standard deviation = 3.2) vs 21.97 mmHg (standard deviation = 2.6); p = 0.766), for mean intraocular pressures and mean intraocular pressure reductions during whole follow-up period. At all follow-up visits, the mean percent intraocular pressure reduction was smaller in the adjunctive selective laser trabeculoplasty group than in the initial selective laser trabeculoplasty group, and such a difference was significant at 1 month (21.55% vs 26.79%; p = 0.039) and 24 months (24.82% vs 28.10%; p = 0.041). According to the Kaplan-Meier survival analysis, the 24-month success rate was 71.4% in the initial selective laser trabeculoplasty group and 71% in the adjunctive selective laser trabeculoplasty group, with no differences between the groups (p = 0.913).

Selective laser trabeculoplasty is equally efficient in reducing intraocular pressure as initial or adjunctive treatment for primary open-angle glaucoma over 24 months.