Outcomes of Selective Laser Trabeculoplasty for Sustained Elevation of Intraocular Pressure Following Intravitreal...

To evaluate the efficacy and predictors of success of selective laser trabeculoplasty (SLT) for sustained elevation of intraocular pressure (SE-IOP) associated with anti-vascular endothelial growth factor (VEGF) therapy.

Retrospective observational case series.

A retrospective chart review was performed for patients who received SLT following one or more anti-VEGF injections at an academic center between January 2013 and June 2022. Exclusionary criteria included history of non-open-angle glaucoma, incisional glaucoma surgery, or SLT more than 24 months after anti-VEGF injections.

Outcomes included mean IOP and medication use up to 24 months following SLT. Failure was defined as less than 20% IOP reduction, increase in medication use, or need for additional laser or surgical interventions.

Thirty-three eyes of 31 patients were identified. Baseline IOP was 25.1 ± 6.1 mmHg on 2.7 ± 1.3 medications. SLT significantly reduced mean IOP but not medication use at all recorded time frames. At 24 months, mean IOP was 17.5 ± 8.2 mmHg (P = 0.009) on 3.1 ± 0.9 medications (P = 0.313). Success rates were 48.5% at 6 months, 32.3% at 12 months, and 23.6% at 24 months. The frequency of anti-VEGF injections (HR: 1.318; 95% CI: 1.072 to 1.623; P = 0.008) was the only significant predictor of SLT success in the multivariate analysis.

SLT may be an effective adjunctive therapy for SE-IOP associated with anti-VEGF injections. The frequency of anti-VEGF injections prior to SLT may be a key predictor of treatment success.