Predictors of selective laser trabeculoplasty success in open angle glaucoma or ocular hypertension: does baseline tonography have a predictive role?

BACKGROUND

The determinants of success of selective laser trabeculoplasty (SLT) in treatment-naïve patients with open angle glaucoma (OAG) and ocular hypertension (OHT) have not been understood fully. Therefore, we have conducted this study to explore the predictors of success.

METHODS

This is a retrospective review of a pre-existing database of patients who had received primary SLT at St Thomas' Hospital, London, UK. Patients with OAG and OHT who had received primary 360° SLT treatment and had reliable baseline tonographic outflow facility (TOF) with minimum of 1 year of follow-up were included. Univariate and multivariate analyses were performed to find the determinants of success.

RESULTS

One hundred and seventy-four patients between August 2006 and February 2010 had received primary 360° SLT treatment and had baseline TOF measurement. Of these, 72 subjects fulfilled the eligibility criteria. In multivariate regression analysis, the only variable associated with success was baseline intraocular pressure (IOP) (R=0.32, beta=-0.51, p<0.001, 95% CI -2.02 to -0.74).

CONCLUSION

To our knowledge, this is the only study investigating the pretreatment TOF (measured with electronic Shiøtz tonography) and IOP as determinants of success 12 month's post-360° SLT in treatment-naïve patients with OAG and OHT. This study demonstrated that pretreatment IOP (and not TOF) is the only determinant of success after primary SLT therapy.