Efficacy and Safety of Selective Laser Trabeculoplasty as a Primary Procedure for Controlling Intraocular Pressure in Primary Open Angle Glaucoma and Ocular Hypertensive Patients

Abstract

Objective: Assessment of the potential efficacy and safety of selective laser trabeculoplasty (SLT) as a primary therapeutic modality for lowering the intraocular pressure (IOP) in high tension open angle glaucoma (OAG) and ocular hypertensive patients (OHT). Methods: Twenty five patients (35 eyes) were enrolled in this prospective interventional longitudinal clinical study, undertaken during the period January 2005 to October 2006. All the laser procedures were done in the Oyoon Eye Center in Cairo, Egypt. Informed consent was taken from the patients after explanation of the procedure. Eighteen patients (25 eyes) had mild to moderate high tension open angle glaucoma, and there were 7 ocular hypertensive patients (10 eyes). Participants underwent selective laser trabeculoplasty (SLT) 180 degrees and followed up over a period of 12 months to assess the intraocular pressure lowering effect after SLT. Possible complications of the procedure were reported. Results: The intraocular pressure (mean ± standard deviation [StDev]) decreased from baseline pre-operative value of 26.78±3.13 mm Hg to 19.34±1.89 mm Hg 12 months after SLT (p<0.001). The average reduction in intraocular pressure (IOP) was 7.44 mm Hg (95% confidence interval 6.45 - 8.41 mm Hg). By the end of the follow up period (12 months), 62.9% of cases (22 eyes) showed IOP decrease by ≥ 30% from the baseline value, and 77.1% of cases (27 eyes)showed IOP decrease by ≥ 25% of baseline IOP. Conclusion: Selective laser trabeculoplasty is an effective IOP lowering modality. It can be used as a primary treatment for open angle glaucoma and ocular hypertensive patients. If the minimal side effects reported are considered, it can be concluded that SLT has a potential safety to be used as primary alternative treatment for open angle glaucoma and ocular hypertensive patients.