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Abstract #58840 Published in IGR 16-3
Prospective Study on the Efficacy of Treating Normal Tension Glaucoma With a Single Session of Selective Laser Trabeculoplasty
Lee JW; Gangwani RA; Chan JC; Lai JSJournal of Glaucoma 2015; 24: 77-80
PURPOSE: The purpose of this study was to investigate the efficacy of selective laser trabeculoplasty (SLT) in the treatment of normal tension glaucoma (NTG). METHODS: This prospective cohort study recruited consecutive cases of NTG on antiglaucoma medication. Cases were excluded for previous glaucoma surgery or laser. All patients underwent a 1-month washout of medication followed by a mean baseline intraocular pressure (IOP) measured at 9 AM, 1 PM, and 5 PM. A 30% reduction from baseline was set as the target IOP. A single session of SLT was performed to 360 degrees of the trabecular meshwork. IOP phasing was repeated at 1 month after SLT and medication was resumed to achieve the target IOP. Patients were followed up to 6 months after SLT. RESULTS: In 83 eyes of 46 subjects, the mean prestudy IOP was 14.2±3.1 mm Hg when on 1.5±0.9 antiglaucoma medication. The mean baseline IOP without medication was 16.1±2.2 mm Hg. The mean SLT shots applied was 187.8±27.5 using a mean energy of 1.0±0.07 mJ. At 1-month post-SLT, the IOP was 12.7±2.0 mm Hg (21.6% IOP reduction) from baseline without medication (P<0.05). The 6-month IOP was 11.4±1.6 mm Hg when on 1.1±1.0 medications, representing a 19.7% reduction from prestudy IOP, a 29.6% reduction from baseline IOP, and a 26.7% reduction in antiglaucoma medication (all P<0.05). A higher baseline IOP was correlated with greater IOP reduction with SLT (r=0.3, P=0.009). CONCLUSIONS: A single session of SLT for NTG achieved an additional 20% reduction in IOP with 27% less medication at 6 months compared with prestudy levels while maintaining a 30% reduction from baseline IOP.
*Department of Ophthalmology, University of Hong Kong, †Department of Ophthalmology, Caritas Medical Centre ‡Department of Ophthalmology, Queen Mary Hospital, Hong Kong, SAR, People's Republic of China.
Full articleClassification:
12.4 Laser trabeculoplasty and other laser treatment of the angle (Part of: 12 Surgical treatment)
9.2.4 Normal pressure glaucoma (Part of: 9 Clinical forms of glaucomas > 9.2 Primary open angle glaucomas)
