[Predictive factors of successful selective laser trabeculoplasty in open-angle glaucoma].

BACKGROUND

The aim of this study was to determine factors that predict successful selective laser trabeculoplasty (SLT) in open-angle glaucoma (OAG).

PATIENTS AND METHODS

In 122 eyes suffering from OAG, treatment was carried out with a frequency-doubled, Q-switched Nd:YAG laser (532 nm). The intraocular pressure (IOP) was measured before the treatment and 1, 3, 6, 12, 18, 24, 30, 36, 42, 48, 54, 60, 66, 72, 78 and 84 months thereafter. Success was defined as an IOP reduction exceeding 20 % of the pretreatment IOP. Correlations between successful SLT and baseline IOP, age, sex, hypertension, diabetes mellitus, family history of glaucoma, previous anterior segment surgery, the grade of trabecular meshwork pigmentation, laser energy used, and local antiglaucoma therapy were determined.

RESULTS

The mean follow-up time was 43.4 months (SD: 25.6). The mean pretreatment IOP was 22.5 mmHg (SD: 2.8). The success rate after 12 months determined from the Kaplan-Meier survival analysis was 88 %, after 24 months 79 %, after 36 months 67 %, after 48 months 58 %, after 60 months 49 % and after 84 months 48 %. We found statistically significant negative correlation betweens successful SLT and the grade of trabecular meshwork pigmentation (r = -0.234; p = 0.01), diabetes mellitus (r = -0.223; p = 0.014). We found no statistically significant correlations between successful SLT and baseline IOP, age, sex, hypertension, family history of glaucoma, previous anterior segment surgery, laser energy used, local antiglaucoma therapy.

CONCLUSION

SLT success in OAG with a mean follow-up time of 43.4 months was significantly predicted by the lower grade of trabecular meshwork pigmentation and the absence of diabetes mellitus.