Baseline eye pressure tied to outcome of selective laser trabeculoplasty


By Reuters Staff

NEW YORK (Reuters Health) - Baseline intraocular pressure (IOP) is the only determinant of success after primary selective laser trabeculoplasty (SLT) for open-angle glaucoma (OAG) or ocular hypertension (OHT), according to a new database review.

SLT is an effective first-line treatment for OAG and OHT, but about a quarter of patients do not respond to primary SLT. Previous studies have shown that pretreatment IOP strongly predicts post-SLT IOP in patients who were also receiving medical therapy, but one study found that lower baseline aqueous-outflow facility was significantly associated with IOP 3 months after SLT.

Dr. Kin Sheng Lim of King's College London and St. Thomas Hospital, in London, and colleagues investigated whether pretreatment IOP or baseline tonographic outflow facility (TOF) predicted success in patients with newly diagnosed mild or moderate OAG or OHT who received primary 360-degree SLT treatment.

The overall success rate, defined as 20% or greater IOP reduction one year post-SLT, was 75%, the team reports in the British Journal of Ophthalmology.

There was no significant linear association between IOP and TOF at one, three, six, and 12 months post-SLT.

In multivariate analysis, baseline IOP was the only parameter that remained significantly associated with IOP at 12 months.

TOF was weakly associated with 12-month IOP in responders, and neither baseline IOP nor TOF was associated with 12-month IOP reduction in nonresponders.

"Pretreatment TOF cannot reliably predict the SLT outcome," the authors conclude.

It remains unclear whether these findings are generalizable to patients with more severe disease.

Dr. Lim did not respond to a request for comments.

SOURCE: British Journal of Ophthalmology, online January 27, 2020.

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