Dossantos Jason, Muser Tyler, Hill Devin, Lesche Stephen, Ahmed Aseef, Belyea David
Department of Ophthalmology, George Washington University School of Medicine and Health Sciences, Washington, USA.
Cureus. 2024 Aug 22;16(8):e67537. doi: 10.7759/cureus.67537. eCollection 2024 Aug.
To examine the impact of selective laser trabeculoplasty (SLT) on intraocular pressure (IOP) in the untreated contralateral eye within 12 months after the procedure.
A retrospective chart review was conducted on patients with primary open-angle, normal-tension, pigmentary, or pseudoexfoliation glaucoma who received 360-degree SLT at George Washington University. Exclusion criteria included prior or subsequent laser or glaucoma surgery within 12 months of SLT, other glaucoma types, or corticosteroid use during follow-up. Primary outcomes were IOP and medication reduction, and SLT success, defined as reducing IOP by ≥20% without additional IOP-lowering procedures or medications. Follow-up occurred at six weeks, six months, and 12 months. Demographic and clinical data were analyzed using ANOVA, paired t-tests, and chi-squared tests.
A total of 125 patients were included, representing a range of backgrounds: African American (57.6%), Caucasian (31.2%), Asian (5.6%), and Hispanic/Latino (4%), and 1.6% did not report their background. Significant reductions in mean IOP and medication numbers were observed in the contralateral eye at six weeks and six months (p<0.05) but not at 12 months. The contralateral eye success rates were 24% at six weeks and six months and 20.8% at 12 months. The contralateral eye was more likely to achieve success if the ipsilateral eye was successful at six weeks (odds ratio (95% confidence interval): 5.05 (1.89-13.48)), six months (16.1 (4.56-57.17)), and 12 months (5.94 (2.07-17.04)) (p<0.001 for all).
First-time SLT results in statistically significant IOP and medication reductions in the contralateral eye at six weeks and six months. The contralateral eye was 5.05-16.1 times more likely to achieve success if the ipsilateral eye was successful within 12 months.
研究选择性激光小梁成形术(SLT)对手术12个月内未治疗的对侧眼眼压(IOP)的影响。
对在乔治华盛顿大学接受360度SLT治疗的原发性开角型、正常眼压型、色素性或假性剥脱性青光眼患者进行回顾性病历审查。排除标准包括在SLT治疗前12个月内或之后进行过激光或青光眼手术、其他青光眼类型或随访期间使用皮质类固醇。主要结局指标为眼压和药物使用减少情况,以及SLT治疗成功,定义为眼压降低≥20%且无需额外的降眼压手术或药物。随访时间为6周、6个月和12个月。使用方差分析、配对t检验和卡方检验对人口统计学和临床数据进行分析。
共纳入125例患者,背景各异:非裔美国人(57.6%)、白种人(31.2%)、亚洲人(5.6%)、西班牙裔/拉丁裔(4%),1.6%未报告其背景。对侧眼在6周和6个月时平均眼压和用药数量显著降低(p<0.05),但在12个月时未降低。对侧眼在6周和6个月时的成功率为24%,12个月时为20.8%。如果同侧眼在6周(优势比(95%置信区间):5.05(1.89 - 13.48))、6个月(16.1(4.56 - 57.17))和12个月(5.94(2.07 - 17.04))时成功,对侧眼更有可能成功(所有p<0.001)。
首次SLT治疗在6周和6个月时可使对侧眼眼压和用药量在统计学上显著降低。如果同侧眼在12个月内成功,对侧眼成功的可能性高5.05至16.1倍。