[Results of selective laser trabeculoplasty (SLT) as initial treatment for normal tension glaucoma].

PURPOSE

A 3-year prospective study was performed to evaluate treatment outcomes following selective laser trabeculoplasty (SLT) used as initial treatment for normal tension glaucoma (NTG).

SUBJECTS AND METHODS

SLT was performed as initial treatment in 42 NTG patients (42 eyes). Thirty-seven of the patients were untreated and 5 patients had discontinued antiglaucoma medications. Two patients were excluded because they did not visit our clinic during the study period. The study was conducted on the remaining subjects (40 eyes of 40 patients).

RESULTS

The intraocular pressure (IOP) was 15.8 +/- 1.8 mmHg before SLT, 13.2 1.9 mmHg after one year, 13.5 +/- 1.9 mmHg after two years, and 13.5 +/- 1.9 mmHg after three years. The IOP after SLT was significantly lower than that before SLT. One month after SLT, the outflow pressure was improved at least 20% (deltaOP) in 92.5% of the patients. The success rate for the effect of IOP reduction at three years after SLT was 40.0% by Kaplan-Meier survival analysis. 27.5% of the patients who had two consecutive deltaOP less than 20%, 25.0% of the patients who had begun antiglaucoma ophthalmic solution, and 15.0% of the patients who had undergone repeated SLT were judged to have reached the endpoint. Kaplan-Meier survival analysis revealed that the success rate for the visual field at three years after SLT was 82.4% (the visual field loss progression was judged to have reached its endpoint when a significant sensitivity loss was first detected in two consecutive points of the same adjacent test points of at least 3 points in the Glaucoma Progressive Analysis for the Humphrey Visual Field Analyzer). Complications included conjunctival hyperemia (52.5%), eye discomfort (12.5%), visual disturbance (blurry vision and photophobia) (10.0%), and eye pain (5.0%). These complications resolved within a few days, and there were no severe complications such as increased IOP or iritis.

CONCLUSION

Our results suggest that SLT is an effective initial treatment for NTG.