Laser trabeculoplasty in newly diagnosed multi-treated glauc
A Study was conducted to evaluate the intraocular pressure (IOP) lowering effect of laser trabeculoplasty (LTP) in eyes which IOP had been substantially reduced by intensive topical treatment for 1 week.

Patients with newly diagnosed open angle glaucoma were randomly assigned to one of three treatments to lower their IOP. 360° argon or limited LTP was conducted a week later. IOP was assessed prior to LTP as well as one, three, six, and twelve months after LTP. The patients had been enrolled in the Glaucoma Intensive Treatment Study (GITS).

Results:
--Mean IOP (± SD) in 152 eyes of 122 patients was 14.0 (± 3.5) mmHg just before LTP.

--For every mmHg higher IOP prior to LTP, the IOP was reduced by an additional 0.6 mmHg at 12 months. The IOP was significantly reduced at all follow-up visits from 2.6 mmHg at one month to 2.1 mmHg at 12 months in eyes with pre-LTP IOP more than 15 mmHg, while no significant IOP reduction was seen in eyes with pre-LTP IOP less than 15 mmHg.

--Older age, argon LTP and male sex were associated with larger IOP reduction after 12 months, whereas presence of exfoliation syndrome was associated with a smaller IOP reduction. No severe complications were reported.

To summarize, the success of LTP was highly dependent on the degree of IOP prior to treatment. Eyes with a preLTP IOP greater than 15 mmHg saw a sustained substantial IOP reduction, while eyes with a preLTP IOP less than 15 mmHg saw no such impact. When a target pressure of less than 15 mmHg is not reached with multitreatment, LTP can be considered.

Source: https://onlinelibrary.wiley.com/doi/10.1111/aos.14576?af=R
Like
Comment
Share