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Abstract #21680 Published in IGR 10-3
The effect of selective laser trabeculoplasty on intraocular pressure in patients with intravitreal steroid-induced elevated intraocular pressure
Rubin B; Taglienti A; Rothman RF; Marcus CH; Serle JBJournal of Glaucoma 2008; 17: 287-292
See also comment(s) by Anastasios Konstas •
PURPOSE: To assess effectiveness of selective laser trabeculoplasty (SLT) in lowering intraocular pressure (IOP) in patients with steroid-induced elevated IOP. METHODS: Retrospective review of 7 patients (7 eyes) with IOP elevation after intravitreal triamcinolone acetonide (4.0 mg/0.1 mL) injections for macular edema (6 patients) or central retinal vein occlusion (1 patient). Three patients had preexisting open angle glaucoma; 2 patients had preexisting ocular hypertension. Time between intraocular corticosteroid injection and subsequent increased IOP ranged from 5 to 29 weeks. After unsuccessful maximum tolerated medical therapy, patients underwent unilateral SLT between April 2003 and June 2005. IOP was measured 4 weeks prelaser; on the day of laser; within 3 weeks, and at 1, 3, and 6 months postlaser. Two-sample t test was used for analysis. RESULTS: The pre-SLT and post-SLT IOP measurements were the major outcome measures used to define the relative success of the SLT procedure. Seven patients were taking 4.0 ± 0.8 ocular hypotensive medications before SLT. Preoperative IOP (mmHg ± SD) 38.4 ± 7.3 decreased postoperative to 25.6 ± 7.1 within 3 weeks (P < 0.003), 25.9 ± 8.8 at 1 month (P < 0.007), 23.9 ± 10.6 at 3 months (P < 0.006), and 15.7 ± 2.2 at 6 months (P < 0.001). Four patients underwent a second SLT procedure. Two patients failed after the 3-month visit. IOP in fellow eyes of all patients was unchanged (P > 0.080). CONCLUSIONS: SLT lowered (P < 0.007) IOP in 5 eyes of 7 patients with steroid-induced increased IOP from 3 weeks to 6 months postoperative. Two patients required additional surgical procedures. Repeat SLT treatments may be necessary. SLT is a temporizing procedure to consider in patients with steroid-induced elevated IOP.
Dr. B. Rubin, Department of Ophthalmology, Mount Sinai School of Medicine, New York, NY, USA
Classification:
9.4.1 Steroid-induced glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
12.4 Laser trabeculoplasty and other laser treatment of the angle (Part of: 12 Surgical treatment)
